Article

People with hereditary and spontaneous spastic paraparesis (HSSP)
report that their legs are stiffer and walking is slower when their legs are cold. OBJECTIVES:
This study explored the effects of prolonged superficial
cooling and warming of the lower leg on walking speed and local measures of
neuromuscular impairments. METHODS: This was a randomised pre- and
post-intervention study of 22 HSSP participants and 19 matched healthy controls.
On 2 separate occasions, one lower leg was cooled or warmed. Measurements
included walking speed and measures of lower limb impairment: ankle movement,
passive muscle stiffness, spasticity (stretch reflex size), amplitude and rate of
force generation in dorsi- and plantarflexors and central and peripheral nerve
conduction time/velocity. RESULTS: For both participants and controls, cooling
decreased walking speed, especially for HSSP participants. For both groups,
cooling decreased the dorsiflexor rate and amplitude of force generation and
peripheral nerve conduction velocity and increased spasticity. Warming increased
dorsiflexor rate of force generation and nerve conduction velocity and decreased
spasticity. CONCLUSIONS: Superficial cooling significantly reduced walking speed
for people with HSSP. Temperature changes were associated with changes in
neuromuscular impairments for both people with spastic paraparesis and controls.
This study does not support the use of localised cooling in rehabilitation for
people with spastic paraparesis as reported in other neurological conditions.
Rehabilitation interventions that help prevent heat loss (insulation) or improve
limb temperature via passive or active means, particularly when the legs and/or
environment are cool, may benefit people with spastic paraparesis.
CI - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.

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