الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
• The aim of the study:
1- To evaluate the effectiveness of using ethyl alcohol 100% for tibial nerve neurolysis in the management of ankle planter flexor spasticity by both clinical and electrophysiological methods.
2- To determine the efficacy of TENS application on the tibial nerves of the spastic limb. This was evaluated by both clinical and electrophysiological methods.
3- To compare between both of them and other conventional physical therapy in the management of ankle-foot spasticity by both clinical and electrophysiological methods.
• This study included 36 patients with ankle-foot spasticity, their ages ranged from 30-70 years with a mean value of (51.5 ± 15.5) years.
• All patients were subjected to the following:
a- Full history taking.
b- Careful general examination.
c- Full neurological and clinical examination.
d- Electrophysiological assessment: by evaluation of the H-amplitude, H max / M max ratio and the H-latency.
• The patients were randomly classified into 3 different groups according to the line of treatment:
Group (I): included 12 patients were injected at the tibial nerves of their spastic limbs by 100% ethyl alcohol in 1% lidocain. Also these patients were subjected to a conventional physical therapy program which was done at a rate of 1session\ every other day for 1 month.
Group (II): included 12 patients, TENS were applied to the tibial nerves of their spastic limbs at frequency of 100 Hz and duration of 100 m/s. Each session last 15 min and applied at a rate of 1 session\every other day for 1 month. Also these patients were subjected to the same previous physical therapy program.
Group (III): included 12 patients were subjected only to the same previous physical therapy program for 1 month which was done at a rate of 1 session\ every other day.
• Outcome measures:
The baseline assessments of all patients of the three groups were performed at the initial presentation and then 4 weeks after the beginning of the treatment program and the efficacy of treatment in all patients was evaluated with the following measures: Grading of spasticity according to Modified Ashworth Scale (MAS)score, Active Range Of Motion (AROM), Passive Range Of Motion (PROM) of the ankle joint , ankle tendon reflex score, ankle clonus score, examination of the gait (if the patient can walk) using a modification of Physician Rating Scale (PRS), Functional evaluation was assessed by the Walking Index for Spinal Cord Injury (WISCI) scale and the electrophysiological evaluation by the assessment of H-reflex amplitude, the ratio (Hmax/Mmax) and assessment of H-latency.