Effects of Low Level Laser Therapy on Wrist Flexors Spasticity and Hand Functions in Patients With Stroke

Spasticity is more often found in the flexors muscles of the upper limb (fingers, wrist, and elbow flexors) and extensor muscles of the lower limb (knee and ankle extensors). Wissel et al observed that spasticity developed most often in elbow (79%), wrist (66%), ankle (66%), and shoulder (58%).9 Lundstrom et al concluded that spasticity is observed more frequently in the upper extremities than in the lower extremities, and Urban et al found a higher degree of spasticity in the upper limb muscles. LLLT is thought to work through several mechanisms. Stimulating ATP production and increasing cellular energy. The therapy can cause vasodilation, improving circulation in the treated area. It may also reduce the production of inflammatory mediators and increase anti-inflammatory factors, while potentially stimulating the synthesis of growth-promoting factors that facilitate tissue healing, and renewal may be stimulated by this therapy. In the context of spasticity management, LLLT has garnered scientific interest as a possible intervention, although its efficacy remains under scrutiny .Hypothesized mechanisms of action include muscle tone reduction through enhanced circulation and decreased inflammation in muscular and adjacent tissues, potentially fostering the relaxation of hypertonic muscles. Certain research indicates that LLLT may modulate the release of neurotransmitters crucial to muscle contraction and relaxation processes.

Inclusion criteria

• forty stroke patients with wrist flexors spasticity from both sex will be participate in this study
• Their age ranges from 45 to 60 years.
• Patients will be referred by neurological consultants.
• preserved cognitive system, i.e., ability to respond to verbal stimul
• Body mass index less than 30.
• Patients will be diagnosed by clinical and radiological examination.
• patients with wrist flexors spasticity according to modified ashworth scale score +1 to 2.

Exclusion criteria

• Patients with contractures, fractures, rigidity, and deformity
• Patients with cognitive impairments.
• Patients with visual, auditory impairment affecting their ability to complete tasks.
• Uncontrolled Diabetic patient.
• Presence of hypoesthesia and/or hyperesthesia of the involved upper limb.
• Other major neurological condition (e.g., Spinal cord injury, multiple sclerosis, Epilepsy, Meningitis, and Brain tumor).
• presence of neoplastic lesions at the site of application