Immediate Effects of Tecar Therapy on Lower Limb to Decrease Hypertonia in Chronic Stroke Survivors. A Randomized Controlled Trial

Introduction: Lower limb hypertonia due to spasticity is a common condition in chronic stroke survivors. Tecar therapy plus functional massage could be a non-invasive strategy to reduce muscle tone in these individuals. Objective: To investigate whether a single session of Tecar therapy in addition to functional massage reduces lower limb spasticity and improves function in stroke survivors. Design: Double-blind randomized controlled clinical trial. Setting: Laboratory of University. Participants: A total of 36 chronic stroke survivors with lower limb spasticity. Interventions: The experimental group received a single 30-minute session of Tecar therapy in combination with functional massage on the triceps surae and quadriceps muscles. The control group received sham treatment (Tecar therapy, without electrical stimulation) plus functional massage. Outcome Measures: The primary outcome measure was the reduction of hypertonia (spasticity) assessed by the Modified Ashworth Scale (MAS). Secondary outcomes measures were gait speed assessed with a 4-meter Walk-Test, standing knee flexion to 90° hip at 0°, change in weight bearing ankle dorsiflexion measured by the Ankle Lunge Test and functional lower limb strength assessed by the 5-times Sit-to-Stand Test. All measurements were performed at baseline, immediately after treatment and at 30-minutes, all by the same assessor. Results: There was a positive effect in the experimental group for hypertonia-spasticity of plantar flexors and quadriceps muscles (MAS-ankle was -0.6±0.7, effect size 0.15) and (MAS-knee was -0.5±0.7 effect size 0.17) after treatment. There was also a positive effect on the weight bearing ankle dorsiflexion for the experimental group 4.3±3.1, effect size 0.16. However, no differences were showed for gait speed, active knee flexion and functional lower limb strength. Conclusion: A single session of Tecar therapy with functional massage reduces immediately plantar flexors and quadriceps muscle tone and increases change in weight bearing ankle dorsiflexion in chronic post-stroke. No adverse effects were found.