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Anti-spastic effects of footbaths in post-stroke patients: a proof-of-principle study
Matsumoto S, Shimodozono M, Etoh S, Noma T, Uema T, Ikeda K, Miyara K, Tanaka N, Kawahira K
Complementary Therapies in Medicine 2014 Dec;22(6):1001-1009
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To investigate whether a footbath inhibits spasticity in the hemiplegic lower limbs of post-stroke patients. DESIGN: Randomized, controlled study. SETTING: Rehabilitation education and research hospital. INTERVENTIONS: Twenty-two post-stroke patients were randomly allocated to control or experimental groups. After relaxing in a supine posture for 30 min, the experimental group subject's legs were immersed in 41 degree C water below the knee joint for 15 min, while the control group remained in a resting posture. MAIN OUTCOME MEASURES: Modified Ashworth Scale (MAS) scores of the affected triceps surae muscle and F-wave parameters (ie, F-wave amplitude, F/M ratio, and F-wave persistence) were recorded before, immediately after, and 30 min after each intervention. Physiological parameters were simultaneously monitored to determine the thermo-therapeutic mechanisms and side effects of footbath usage. RESULTS: At the time immediately after the intervention, F-wave amplitudes decreased significantly in the experimental group, compared to the control group (p < 0.01, difference -106.8; 95% CI -181.58 to -32.09). F-wave amplitudes decreased significantly after 30-min intervention in the experimental group, with a total reduction of 161.2 micro-V being recorded compared to 8.8 micro-V increase in the control group (p < 0.01, difference -170.0; 95% CI -252.73 to -87.33). There were also significant differences between the experimental and control group for both F/M ratio and F-wave persistence, immediately after and 30 min after the intervention. Further, there were significant differences between the experimental and control group for the MAS scores immediately after the intervention (p < 0.05, difference -0.72; 95% CI -1.262 to -0.193), and 30 min after the intervention (p < 0.05, difference -0.73; 95% CI -1.162 to -0.293). CONCLUSION: These findings demonstrate that the use of footbaths is an effective non-pharmacological anti-spastic treatment for use in stroke rehabilitation.

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