Efficacy of cryo-airflow therapy on calf muscle spasticity in stroke patients: A randomized controlled trial

Aim: To determine the effect of cryo-airflow therapy on spasticity of calf muscle in stroke patients. Material and Method: This randomized control study, took place in the outpatient clinic of Mansoura General Hospital and Mansoura University Hospital, Mansoura, Egypt. Thirty stroke patients were divided into two groups and assigned randomly into the study group (n=15), which received cryo-airflow therapy, a conventional physical therapy program, and advised to wear a night ankle foot orthosis (AFO), or into the control group (n=15), which received the same program, but without the cryo-airflow therapy. Pre and post-treatment assessment for all patients was done by the modified Ashworth’s scale (MAS), the Hoffman reflex / Myogenic response (H/M) ratio of the soleus muscle on the affected side, and by two-dimensional (2D) motion analysis for ankle dorsiflexion range of motion (ROM) during the stance phase of gait. Results: Mann–Whitney and MANOVA tests revealed a significant improvement of MAS scores (p = 0.006) and ankle ROM scores (p = 0.005), while the difference in H/M ratios was non-significant (p = 0.063) in the comparison between study and control groups. Clinical and electrophysiological measures of spasticity were significantly correlated with each other (ρ = 0.765) and negatively with the ankle ROM (ρ =-0.635) when analyzed by Spearman correlation coefficient at (p = 0.000). Discussion: Cryo-airflow therapy is considered to be an effective method to reduce spasticity in calf muscle and to improve ankle dorsiflexion ROM of the affected limb in stroke patients.