Résumé
Contexte : L’incidence de l’accident vasculaire cérébral (AVC) est en constante augmentation, notamment en raison du vieillissement de la population. Il engendre de nombreuses déficiences telles que la spasticité. Celle-ci peut être expliquée par différents mécanismes physiologiques encore mal connus et diminue l’autonomie ainsi que la qualité de vie des patients. La thérapie thermique n’a jusqu’à présent pas fait l’objet d’une revue de la littérature pour la prise en charge de la spasticité. Objectif : L’objectif de cette revue de la littérature consiste à évaluer l’effet des différentes thérapies thermiques sur la spasticité des patients post-AVC. Méthode : Une recherche dans les bases de données PubMed, CINAHL, PEDRO et Embase a permis de retenir cinq essais contrôlés randomisés (RCT), incluant au total 149 patients. Résultats : Deux études traitent de thermothérapie, deux de cryothérapie et une de thérapie thermique par contraste. La thermothérapie a démontré un effet significatif intergroupe directement et 30 minutes après l’intervention sur l’échelle d’Ashworth modifiée (MAS), auquel s’ajoute un effet cumulatif après 4 semaines de traitement. La cryothérapie démontre également un effet significatif intergroupe sur la MAS directement et 4 semaines après l’intervention. Le protocole de thérapie thermique par contraste n’a pas montré de résultats significatifs après 6 semaines d’intervention. Conclusion : Une recommandation faible selon le Grading of Recommendations, Assessment, Development and Evaluations (GRADE) concernant l’utilisation de thérapie thermique pour traiter la spasticité peut être émise. Des études de meilleure qualité sont nécessaires pour augmenter le niveau de recommandation ainsi que pour connaitre les effets de l’utilisation des différentes thérapies thermiques sur la fonction des patients.
Background: The incidence of stroke is constantly increasing due to an aging population. Strokes cause numerous deficiencies, such as spasticity. Spasticity can be explained by different physiological mechanisms that are still not well known. Strokes can also reduce autonomy and quality of life. Thermal therapy has not yet been reviewed in the literature on the treatment of spasticity. Objective: This literature review aims to evaluate the effect of different thermal therapies on spasticity in post stroke patients. Method: A search of the PubMed, CINAHL, PEDRO, and Embase databases resulted in the selection of five randomized control trials (RCT), which included a total of 149 patients. Results: Two studies dealt with thermotherapy, two with cryotherapy, and one with thermal contrast therapy. Thermotherapy was assessed with the Modified Ashworth Scale (MAS) and had a significant intergroup effect immediately following and 30 minutes after the intervention, with a cumulative effect after four weeks of treatment. The effects of cryotherapy were also measured on the MAS, and cryotherapy had a significant effect immediately following and four weeks after the intervention. The thermal contrast therapy protocols did not show significant results after six weeks of intervention. Conclusion: A weak recommendation on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for the use of thermal therapy to treat spasticity can be made. More in-depth studies are needed to increase the level of the recommendation as well as to better understand the effects of the use of different thermal therapies on the patient’s function.
Background: The incidence of stroke is constantly increasing due to an aging population. Strokes cause numerous deficiencies, such as spasticity. Spasticity can be explained by different physiological mechanisms that are still not well known. Strokes can also reduce autonomy and quality of life. Thermal therapy has not yet been reviewed in the literature on the treatment of spasticity. Objective: This literature review aims to evaluate the effect of different thermal therapies on spasticity in post stroke patients. Method: A search of the PubMed, CINAHL, PEDRO, and Embase databases resulted in the selection of five randomized control trials (RCT), which included a total of 149 patients. Results: Two studies dealt with thermotherapy, two with cryotherapy, and one with thermal contrast therapy. Thermotherapy was assessed with the Modified Ashworth Scale (MAS) and had a significant intergroup effect immediately following and 30 minutes after the intervention, with a cumulative effect after four weeks of treatment. The effects of cryotherapy were also measured on the MAS, and cryotherapy had a significant effect immediately following and four weeks after the intervention. The thermal contrast therapy protocols did not show significant results after six weeks of intervention. Conclusion: A weak recommendation on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for the use of thermal therapy to treat spasticity can be made. More in-depth studies are needed to increase the level of the recommendation as well as to better understand the effects of the use of different thermal therapies on the patient’s function.