BACKGROUND: Oppositional paratonia is a form of hypertonia in late-stage dementia. Grooming and dressing of patients with oppositional paratonia is a problem for the carer and nurses. Passive movement therapy (PMT) is the main physiotherapeutic intervention. AIM: To determine whether PMT is beneficial in these patients. METHODS: This randomized clinical trial involved residents of the nursing home 'De Weerde' at Eindhoven, the Netherlands. Subjects were randomized over three groups: group 1 received PMT (3 sessions a week), group 2 used stabilizing cushions, and group 3 acted as a control group. Nine treatment sessions were given, and subjects were evaluated before and after each session, using a modified Ashworth scale for paratonia. All four limbs were assessed in four movement directions (flexion, extension, abduction, and adduction). RESULTS: Fifteen patients from the psychogeriatric department of the nursing home 'De Weerde' were included after screening and proxy consent. The only statistically significant difference between the three groups was for improved extension of the left leg after 3 weeks in the control group p = 0.016. However, trend analyses showed that PMT was beneficial after 1 treatment session. Stabilising cushions were the most beneficial for both arms after 3 weeks of treatment. Stabilising cushions were beneficial for flexion of both legs after 1 treatment but were not beneficial for extension of both legs, and certainly not after 3 weeks. CONCLUSION: Passive movement therapy and stabilising cushions both appear to be beneficial interventions for oppositional paratonia. However, generalization to all limbs and all movement directions is not possible.

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