The Effect of Cupping on Spasticity and Function of the Lower Extremity During Rehabilitation After Stroke

The Modified Ashworth Scale measures spasticity on a 0-4 ordinal scale, with higher scores indicating greater spasticity. The grade is determined by passively moving a joint/muscle through a high velocity unidirectional quick stretch. For this study, spasticity will be assessed for the hip adductors and hamstrings of the affected side.

Equipment:

Mat Table

Administration:

Patient is positioned in supine on a mat table.

For Hip Adduction: Physical therapist passively moves the affected lower extremity into hip abduction quickly keeping the knee in extension.

For Hamstrings: Physical therapist passively moves the hip to 90 degrees of flexion and allows the knee to bend into knee flexion. Then, the therapist passively moves the affected knee into extension quickly.

The Six-minute Walk Test is a measure of aerobic capacity and gait. It is measured in feet on a ratio scale.

Administration:

The patient is instructed to walk down an unobstructed path for six minutes, while the physical therapist walks behind them with a stopwatch and rolling tape measure to monitor the time and steps of the patient during the test. The distance (in feet) that the patient walked, after six minutes, is used as the score for the test.

To note: blood pressure will be taken before and after the test.

The TUG assesses mobility, ability, and fall risk in older adults. It is measured in seconds, on a ratio scale.

Equipment:

• Chair with armrests
• Stopwatch
• Marker to designate 10' turn around point

Administration:

• The patient sits in the chair
• On the command "ready and go" the patient gets up from the chair, walks 10 feet at a comfortable and safe pace, turns, walks back to the chair and sits down.
• Timing begins at the instruction "go" and stops when the patient is seated
• The patient must use the same assistive device for each assessment time, but is able to complete the test with multiple devices or no device.
• The physical therapist will demonstrate the activity to the patient.

The Berg Balance Scale is a 14-item test that measures static balance and fall risk in adults. Each item is scored on a 0-4 ordinal scale. At conclusion of the 14 items, the score is tallied.

Equipment: Chair with arms, Chair without arms, Mat, Stopwatch, Yardstick, Slipper/sandal, 7 ¾" step, Blind fold, Tape.

Items (14):

• sitting to standing
• standing unsupported
• sitting unsupported with feet on floor
• standing to sitting
• transfers
• standing unsupported with eyes closed
• standing unsupported with feet together
• reaching forward with outstretched arm
• pick up object from floor
• turn to look behind over each shoulder
• turning 360 degrees
• dynamic weight shifting while standing unsupported
• standing unsupported one foot in front
• standing on one leg