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14.11 Hemiplegia - Spasticity
This chapter examines the treatment of problems specific to the hemiplegic patient, including spasticity,
which is found not only in hemiplegic patients but also in most disorders of the central nervous system
(tetraplegia, paraplegia, multiple sclerosis, etc.).
The practical methods of treatment described in this chapter are based on the following reference
publications:
1. Wal J.B.
Modulation of Spasticity: Prolonged Suppression of a Spinal Reflex by Electrical Stimulation. Science 216:
203 - 204, 1982
2. Baker L.L., Yeh C., Wilson D., Waters R.L.
Electrical Stimulation of Wrist and Fingers for Hemiplegic Patients. Physical Therapy 59: 1495 - 1499, 1979
3. Alfieri V.
Electrical Treatment of Spasticity. Scand. J Rehab Med 14: 177 - 182,
4. Carnstan B., Larsson L., Prevec T.
Improvement of Gait Following Electrical Stimulation. Scand J Rehab Med 9: 7 - 13, 1977
5. Waters R., McNeal D., Perry J. Experimental Correction of Foot Drop by Electrical Stimulation of the
Peroneal Nerve. J Bone Joint Surg (Am) 57: 1047 - 54, 1975
6. Liberson WT, Holmquest HJ, Scot D
Functional Electrotherapy: Stimulation of the Peroneal Nerve Synchronized with the Swing Phase of the
Gait Hemiplegic Patient. Arch Phys Med Rehabil 42: 101 - 105, 1961
7. Levin MG, Knott M, Kabat H
Relaxation of Spasticity by Electrical Stimulation of Antagonist Muscles. Arch Phys Med 33: 668 - 673, 1952
The treatments discussed in this chapter are applicable through the programmes in the
Neurological Rehabilitation category and some of these programmes require each contraction to be
manually triggered.
All programmes used reduce spasticity as long as they are applied correctly to the muscles antagonistic
to the spastic muscles. Some of these programmes are intended solely for the treatment of spasticity,
while others are intended to treat situations or complications specific to the hemiplegic patient, namely:
functional neuromuscular electrical stimulation of the foot and subluxation of the shoulder.