PJM and Cryotherapy in a New Approach for Spasticity Management: An Experimental Trial

Background: Spasticity has been proven to affect the quality of life and functional rehabilitation in patients post-stroke. Several studies aimed to investigate ways to reduce muscle tonicity in this population. Peripheral joint mobilization (PJM) as well as cryotherapy can be used effectively to reduce spasticity and enhance the range of motion. Objectives: This study aimed to investigate the direct effect of cryotherapy, and that of peripheral joint mobilization, on spasticity as a primary outcome and range of motion as a secondary outcome in stroke patients. Methods: Eighteen participants met the inclusion criteria. Patients with ankle plantarflexor spasticity (n=14), patients with biceps brachii spasticity (n=13), and patients with triceps brachii spasticity (n=10) underwent our interventions on two distinct visits. On the first session, Kaltenborn’s PJM was performed, while on the second session ice-massaging technique was applied on the biceps brachii, triceps brachii, and gastrocnemius muscles over the duration of five continuous minutes. The assessment tools used were Modified ashworth scale (MAS) to assess spasticity level and goniometer to evaluate the range of motion (ROM). Statistical tests were performed using SPSS software, Version 23.0. Results: Cryotherapy and peripheral joint mobilization showed a significant reduction in spasticity of the biceps brachii and triceps brachii muscles (p < 0.05), while only cryotherapy had a significant change on gastrocnemius muscle. For ROM, only PJM showed a significant positive change on both active and passive ranges. Conclusion: Both modalities showed effectiveness in direct reduction of spasticity, hence contributing to a more manageable and practical functional rehabilitation of stroke patients