Effect of isokinetic continuous passive mobilization in spastic hemiplegia

Abstract

Cerebrovascular Accidents (CVA) often affect the central nervous system (CNS) function. The primary concern addressed in physical rehabilitation is the restoration of the motor function required to perform activities of daily living (ADL), such as grasping, reaching and performing complex movements. Motor tasks depend on the control of muscular strength, which is compromised by damage to the CNS and manifests as impaired coordination, hyperreflexia or spasticity and unilateral muscular weakness. Several methods are used to quantify spasticity. The isokinetic dynamometer seems to be a more effective device, as it allows for the standardization of joint angles, speed of stretching and positioning, in addition to minimizing the subjectivity of the evaluation. Therefore, our objective was to analyze the effect of the continuous passive mobilization at two speeds (120º/s and 180º/s) in hemiplegic patients with spasticity. Five patients of both sexes between 40 - 55 years old with a history of CVA and accompanying spasticity were enrolled in the study. All patients presented degree 2 spastic extensor muscles of the knee joint at the Modified Scale of Ashworth and degrees 0, 1 and 1+ flexor muscles at the same scale. All the individuals were submitted to continuous passive mobilization by an isokinetic dynamometer at speeds of 120º/second and 180º/second with 30 repetitions of each. The results showed a significant reduction of passive resistance after the 6th repetition, regardless of the angular velocities. We concluded that continuous passive mobilization by an isokinetic dynamometer is an effective way to quickly measure and reduce spasticity.