Effects of superficial heating and insulation on walking speed in people with hereditary and spontaneous spastic paraparesis: A randomised crossover study / A. Denton in Annals of physical and rehabilitation medicine, Vol. 61, n°2 (Mars 2018)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 61, n°2 (Mars 2018) . - p. 72-77 Titre : Effects of superficial heating and insulation on walking speed in people with hereditary and spontaneous spastic paraparesis: A randomised crossover study Type de document : texte imprimé Auteurs : A. Denton ; A. Hough ; Jennifer A. Freeman ; Jonathan F. Marsden Année de publication : 2018 Article en page(s) : p. 72-77 Note générale : Doi : 10.1016/j.rehab.2017.12.001 Langues : Anglais (eng) Mots-clés : Hyperthermia induced  Walking  Spastic paraparesis Résumé : Objectives Cooling of the lower limb in people with Hereditary and Spontaneous Spastic Paraparesis (pwHSSP) has been shown to affect walking speed and neuromuscular impairments. The investigation of practical strategies, which may help to alleviate these problems is important. The potential of superficial heat to improve walking speed has not been explored in pwHSSP. Primary objective was to explore whether the application of superficial heat (hot packs) to lower limbs in pwHSSP improves walking speed. Secondary objective was to explore whether wearing insulation after heating would prolong any benefits. Methods A randomised crossover study design with 21 pwHSSP. On two separate occasions two hot packs and an insulating wrap (Neo-G™) were applied for 30minutes to the lower limbs of pwHSSP. On one occasion the insulating wrap was maintained for a further 30minutes and on the other occasion it was removed. Measures of temperature (skin, room and core), walking speed (10 metre timed walk) and co-ordination (foot tap time) were taken at baseline (T1), after 30 mins (T2) and at one hour (T3). Results All 21 pwHSSP reported increased lower limb stiffness and decreased walking ability when their legs were cold. After thirty minutes of heating, improvements were seen in walking speed (12.2%, P<0.0001, effect size 0.18) and foot tap time (21.5%, P<0.0001, effect size 0.59). Continuing to wear insulation for a further 30minutes gave no additional benefit; with significant improvements in walking speed maintained at one hour (9.9%, P>0.001) in both conditions. Conclusions Application of 30minutes superficial heating moderately improved walking speed in pwHSSP with effects maintained at 1hour. The use of hot packs applied to lower limbs should be the focus of further research for the clinical management of pwHSSP who report increased stiffness of limbs in cold weather and do not have sensory deficits. Permalink : ./index.php?lvl=notice_display&id=80449 [article] Effects of superficial heating and insulation on walking speed in people with hereditary and spontaneous spastic paraparesis: A randomised crossover study [texte imprimé] / A. Denton ; A. Hough ; Jennifer A. Freeman ; Jonathan F. Marsden . - 2018 . - p. 72-77. Doi : 10.1016/j.rehab.2017.12.001 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 61, n°2 (Mars 2018) . - p. 72-77 Mots-clés : Hyperthermia induced  Walking  Spastic paraparesis Résumé : Objectives Cooling of the lower limb in people with Hereditary and Spontaneous Spastic Paraparesis (pwHSSP) has been shown to affect walking speed and neuromuscular impairments. The investigation of practical strategies, which may help to alleviate these problems is important. The potential of superficial heat to improve walking speed has not been explored in pwHSSP. Primary objective was to explore whether the application of superficial heat (hot packs) to lower limbs in pwHSSP improves walking speed. Secondary objective was to explore whether wearing insulation after heating would prolong any benefits. Methods A randomised crossover study design with 21 pwHSSP. On two separate occasions two hot packs and an insulating wrap (Neo-G™) were applied for 30minutes to the lower limbs of pwHSSP. On one occasion the insulating wrap was maintained for a further 30minutes and on the other occasion it was removed. Measures of temperature (skin, room and core), walking speed (10 metre timed walk) and co-ordination (foot tap time) were taken at baseline (T1), after 30 mins (T2) and at one hour (T3). Results All 21 pwHSSP reported increased lower limb stiffness and decreased walking ability when their legs were cold. After thirty minutes of heating, improvements were seen in walking speed (12.2%, P<0.0001, effect size 0.18) and foot tap time (21.5%, P<0.0001, effect size 0.59). Continuing to wear insulation for a further 30minutes gave no additional benefit; with significant improvements in walking speed maintained at one hour (9.9%, P>0.001) in both conditions. Conclusions Application of 30minutes superficial heating moderately improved walking speed in pwHSSP with effects maintained at 1hour. The use of hot packs applied to lower limbs should be the focus of further research for the clinical management of pwHSSP who report increased stiffness of limbs in cold weather and do not have sensory deficits. Permalink : ./index.php?lvl=notice_display&id=80449

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Superficial warming and cooling of the leg affects walking speed and neuromuscular impairments in people with spastic paraparesis / A. Denton in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 326-332 Titre : Superficial warming and cooling of the leg affects walking speed and neuromuscular impairments in people with spastic paraparesis Type de document : texte imprimé Auteurs : A. Denton ; L. Bunn ; A. Hough ; [et al...] Année de publication : 2016 Article en page(s) : p. 326-332 Langues : Français (fre) Mots-clés : Temperature  Neural conduction  Muscle spasticity  Spastic paraparesis Résumé : Background People with hereditary and spontaneous spastic paraparesis (HSSP) report that their legs are stiffer and walking is slower when their legs are cold. Objectives This study explored the effects of prolonged superficial cooling and warming of the lower leg on walking speed and local measures of neuromuscular impairments. Methods This was a randomised pre- and post-intervention study of 22 HSSP participants and 19 matched healthy controls. On 2 separate occasions, one lower leg was cooled or warmed. Measurements included walking speed and measures of lower limb impairment: ankle movement, passive muscle stiffness, spasticity (stretch reflex size), amplitude and rate of force generation in dorsi- and plantarflexors and central and peripheral nerve conduction time/velocity. Results For both participants and controls, cooling decreased walking speed, especially for HSSP participants. For both groups, cooling decreased the dorsiflexor rate and amplitude of force generation and peripheral nerve conduction velocity and increased spasticity. Warming increased dorsiflexor rate of force generation and nerve conduction velocity and decreased spasticity. Conclusions Superficial cooling significantly reduced walking speed for people with HSSP. Temperature changes were associated with changes in neuromuscular impairments for both people with spastic paraparesis and controls. This study does not support the use of localised cooling in rehabilitation for people with spastic paraparesis as reported in other neurological conditions. Rehabilitation interventions that help prevent heat loss (insulation) or improve limb temperature via passive or active means, particularly when the legs and/or environment are cool, may benefit people with spastic paraparesis. Permalink : ./index.php?lvl=notice_display&id=47167 [article] Superficial warming and cooling of the leg affects walking speed and neuromuscular impairments in people with spastic paraparesis [texte imprimé] / A. Denton ; L. Bunn ; A. Hough ; [et al...] . - 2016 . - p. 326-332. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 326-332 Mots-clés : Temperature  Neural conduction  Muscle spasticity  Spastic paraparesis Résumé : Background People with hereditary and spontaneous spastic paraparesis (HSSP) report that their legs are stiffer and walking is slower when their legs are cold. Objectives This study explored the effects of prolonged superficial cooling and warming of the lower leg on walking speed and local measures of neuromuscular impairments. Methods This was a randomised pre- and post-intervention study of 22 HSSP participants and 19 matched healthy controls. On 2 separate occasions, one lower leg was cooled or warmed. Measurements included walking speed and measures of lower limb impairment: ankle movement, passive muscle stiffness, spasticity (stretch reflex size), amplitude and rate of force generation in dorsi- and plantarflexors and central and peripheral nerve conduction time/velocity. Results For both participants and controls, cooling decreased walking speed, especially for HSSP participants. For both groups, cooling decreased the dorsiflexor rate and amplitude of force generation and peripheral nerve conduction velocity and increased spasticity. Warming increased dorsiflexor rate of force generation and nerve conduction velocity and decreased spasticity. Conclusions Superficial cooling significantly reduced walking speed for people with HSSP. Temperature changes were associated with changes in neuromuscular impairments for both people with spastic paraparesis and controls. This study does not support the use of localised cooling in rehabilitation for people with spastic paraparesis as reported in other neurological conditions. Rehabilitation interventions that help prevent heat loss (insulation) or improve limb temperature via passive or active means, particularly when the legs and/or environment are cool, may benefit people with spastic paraparesis. Permalink : ./index.php?lvl=notice_display&id=47167

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