Low Level LASER Therapy in Chronic Stroke Patients With Spastic Planter Flexors.
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Low-intensity LASER therapy on the spastic muscle, would result in improving muscle
      performance and improving the functional capacity of individuals under the exercises imposed
      by physical therapy. In this study the effect of low level LASER therapy will be evaluated on
      spastic planter flexor of chronic stroke patients and on their gait parameters. After this
      study post stroke planter flexor spasticity will be cured by low level LASER which will help
      to improve their gait mechanics.
    

Detailed description: 
      Cerebrovascular accident (CVA) is defined as interruption of brain blood supply, which may
      affect basic motor functions, including spasticity. This post-stroke spasticity causes pain,
      muscle force reduction, changes in gait parameters and decreases the time to onset of muscle
      fatigue. These factors may lead to difficulty in maintaining an effective and comfortable
      speed when walking due to high-energy demand and the deficit of aerobic endurance,
      compromising the functional mobility in chronic stroke patients. Several therapeutic
      resources have been employed to treat post-stroke spasticity and functional recovery, one of
      the latest therapy which is used for muscular rehabilitation is Low-level LASER therapy
      (LLLT). The effect of LLLT on specific spastic muscle groups has not yet been studied in
      detail in those of chronic stroke patients.

      The aim of this study is to evaluate the effect of the application of LLLT on spastic plantar
      flexor muscles and on gait parameters in patients with chronic stroke.Lower limb spasticity
      can result in the sustained over activity of the triceps surae muscle, which then leads to
      the equinus of the foot. The equinus foot can cause ankle instability during the loading
      response phase and poor toe clearance during the swing phase of gait.

      Spastic drop foot is around 20% in stroke survivors. Spastic foot drop occurs primarily due
      to a combination of weakness of ankle dorsiflexors and spasticity of plantar flexors,
      associated with weakness of ankle evertors and/or spasticity of invertors. Spastic drop foot
      prevents heel strike, impairs walking, limits the activities of daily living, and contributes
      to injuries) LLLT is widely used in the clinic and encompasses a range of non-invasive
      therapeutic aspects. LLLT is commonly used clinically as a red light near-infrared wave with
      a length of 600 to 1000 nm and 5 to 500 mW.5 On the contrary, lasers used in surgery have a
      wavelength of 300 nm.6 Low-power lasers are capable of penetrating deep into the skin so that
      the surface of the skin does not burn and damage Low-power or cold lasers have been enhanced
      to the point of being able to produce analgesia and healing acceleration for many clinical
      conditions.A wide range of LLLT and related techniques have been used. Therefore, the results
      of treatment with low-power lasers may contradict each other.

      The randomized controlled trial will recruit patients according to consecutive sampling into
      the control group and intervention group. The Control group will receive conventional
      treatment of spasticity, hot pack for 15 to 20 minutes followed by 10 repetitions of
      sustained stretching (10 seconds hold), strengthening exercise, balance training and gait
      training for eight weeks and two sessions each week and the interventional group will receive
      Low-level LASER therapy for eight weeks and two session per week in addition to the
      conventional therapy. For this study, we will use The Modified Ashworth Scale (for
      spasticity), goniometer (for muscle angle), and Wisconsin gait scale (for gait parameters) as
      tools of assessment. Data will be analyzed on SPSS software version 25.
    

Intervention name(s): Low level LASER therapy; Conventional physical therapy
Intervention type(s): Other; Other
Intervention description(s): Three consecutive treatments will be given in a session, with 5 seconds break in between, giving a total irradiation time of 90 seconds. Two sessions will be given per week for total of 6 weeks.(20); Hot pack for 15 to 20 minutes followed by 10 repetitions of sustained stretching (10 seconds hold), for 3 days a week for 6 week
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stroke; Muscle Spasticity; Gait Analysis; Low-Level Laser Therapy