Turkish Journal of Physical Medicine and Rehabilitation 2003 , Vol 49 , Num 4
İnmeli Hastalarda Farklı Süreli Soğuk ve Sıcak Paket Uygulamalarının El Bilek Fleksör Spastisitesine Etkisinin İzokinetik Yöntemle Belirlenmesi
Dilek Karakuş 1 ,Murat Ersöz 2 ,Belgin Karaoğlan 3 ,Sibel Özbudak Demir 1
1 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara, Türkiye
2 Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
3 Gazi Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara, Türkiye

Spasticity in stroke often interferes with function, limits independence and may produce secondary complications such as contractures. Cold and hot packs are widely used for decreasing spasticity but the optimum duration and the efficacy are controversial. In this study the effect of cold and hot pack applications with changing durations on the flexor wrist spasticity in stroke patients was investigated. Resistance to passive wrist extension at 60 and 120 degrees/sec velocities were measured using an isokinetic dynamometer in 16 stroke patients (mean age: 58.2±9.7 years) who had flexor wrist spasticity. Baseline spasticity was measured at the first day and measurements were taken after 10, 15, 20 minutes long cold pack and 20 minutes long hot pack applications respectively in the following four days. Although mild increases were observed after 15 and 20 minutes of cold applications, there were no significant differences among peak torque values (3.7±0.9, 3.7±1.0, 4.0±1.2, 3.9±1.1, 3.7±0.9 Nm respectively) at 60 degrees/sec (p=0.311) and at 120 degrees/sec (3.6±0.9, 3.8±1.0, 4.0±1.2, 3.9±1.2, 3.9±0.9 Nm respectively) (p=0.314). Cold and hot pack applications up to 20 minutes did not diminish flexor wrist spasticity in stroke patients. Further studies with different methodology, larger sample size and longer application time will be helpful in determination of the effect of cold and hot pack applications on spasticity

Keywords : Stroke, spasticity, cold pack, hot pack, isokinetic dynamometer