Effects Of Neurodynamics on Spasticity in Upper Extremity of Stroke Patients

Abstract

Stroke leads to long term disability and spasticity is one of them. Neurodynamic is a movement which aimed to restore the electrical signal directed to the nerve and the spinal cord. The neural mobilization is used to restore the movement and improve elasticity of nervous system to improve the arm function and regain the motor ability in patients with stroke.  Objective: To assess the effects of neurodynamics on spasticity in upper extremities of stroke patients. Methods: It is a Randomized controlled trial. Data was collected from 46 stroke Patients. Simple Random Sampling was done and data was collected from District headquarters hospital (DHQ) Jhelum. Patients with chronic stroke, age 40-60 years, Modified Ashworth Scale (MAS) ≥1 to 3 and both male and female were included in this study. For 6 weeks, the experimental group received conventional therapy with neurodynamics (10 reps/ set, 1 set/ day, 3 days/week), whereas the control group received conventional treatment (12 reps/ set, 1 set/ day, 3 days/week). The MAS, Fugl Meyer Upper Extremity Scale (FMUE), goniometry and Action Research Arm Test were used to examine the participants at zero, three, and six weeks (ARAT). The Shapiro-Wilk test was used to ensure that the data was normal, and statistical analysis was performed using SPSS 21. Results: Statistically significant improvement was found in between group analyses in MAS, FM-UE motor score and AROM as the p-value was <0.05. There was no significant difference in ARAT, FM-UE sensation, joint pain, passive joint motion, coordination and PROM as p-value was >0.05. Statistically significant improvement was found in within group analyses in MAS, FM-UE motor score, sensation, joint pain, AROM and PROM as the p-value was <0.05 except in ARAT and FM-UE coordination. Conclusion: The result shows that neurodynamic combined with conventional treatment was more effective than conventional treatment alone to reduce spasticity, improve upper extremity function and AROM. The result also shows that there was significant improvement in upper extremity joint pain, sensation and PROM and no improvement occurred in coordination and fine task performance within groups. The study concludes that neurodynamic is effective for spasticity and has additional benefit in improving UE functional performance and active range of motion but the effects of neurodynamic combined with conventional treatment are no different than conventional treatment alone on passive range of motion, joint pain, coordination, fine task performance and sensation.