We studied the effects of electrical stimulation of the skin on upper extremity spasticity in nine hemiparetic stroke subjects. The effects were quantified by comparing reflex torque responses elicited during ramp and hold angular perturbations of the elbow recorded before and after low-intensity skin stimulation. Electrical stimulation was applied to skin over the biceps muscle for a period of ten minutes at a 20 Hz frequency, pulse duration 0.1 ms, with an intensity level below motor threshold but above sensory threshold. In seven of the nine subjects, stimulation of skin over spastic muscle reduced peak torque responses in both flexors and extensors for at least 30 min. In these seven subjects there were significant increases in mean threshold angle for the onset of reflex torque so that a greater angular rotation was required to initiate the stretch reflex response. This shift occurred without change in reflex impedance. The origins of these long-term changes in reflex torque are unclear, but may reflect synaptic plasticity of spinal circuitry outside the stretch reflex loop.
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