Quantitative evaluation of the stretch reflex before and after hydro kinesy therapy in patients affected by spastic paresis

The aim of this study was the quantitative evaluation of the myotatic refle x in a group of 26 patients affected by stationary spastic paresis (6: hemi paresis; 5: paraparesis; 8: tetraparesis; 7: multiple sclerosis) before and after a treatment of hydro-kinesy therapy. The treatment was carried out i n an indoor pool containing warm (32 degrees C) sea water and consisted of active and passive motion exercises, coordination exercises and immersion w alking. The measured parameters were: (i) the peak input force (F-pH) measu red by means of an instrumented hammer with which the patellar tendon was h it; and (ii) the peak value of the corresponding reflex force of the quadri ceps femoris (F-pQ) measured by means of a load cell connected to the subje ct's ankle. The peak values of the reflex response (F-pQ) were found to inc rease as a function of the intensity of the imposed stimulus and to reach a plateau between 15 and 30 N of F-pH, A Student's t test applied to the pai red values of F-pQ (as measured at plateau conditions) on both the lower li mbs, before and after therapy, showed no significant changes due to the tre atment in the four groups of subjects. However, if all subjects were groupe d regardless the type of illness: 1) the average reflex response of the aff ected limb (the one characterized before therapy by the higher F-pQ values) was found to decrease following the treatment (75.1 +/- 26.7 N pre therapy and 69.1 +/- 29.3 N post therapy, p = 0.07, n = 26); and 2) the effect of the treatment was found to be significantly larger (p = 0.04, n = 26) on th e affected limb (Delta F-pQ = 6.07 +/- 16.5 N) as respect with the contra l ateral one (Delta F-pQ = -0.16 +/- 12.1 N). (C) 1999 Elsevier Science Ltd. All rights reserved.