Effects of Repetitive Facilitative Exercise on Spasticity in the Upper Paretic Limb After Subacute Stroke

J Stroke Cerebrovasc Dis. 2018 Oct;27(10):2863-2868. doi: 10.1016/j.jstrokecerebrovasdis.2018.06.013. Epub 2018 Jul 30.


Background: Repetitive facilitative exercise is an effective method for recovery of the affected limb in stroke patients. However, its effects on spasticity are unknown. We aimed to determine the effects of repetitive facilitative exercise on spasticity using the Modified Ashworth Scale (MAS) and the F-wave, and to determine the relationship between the changes in spasticity and functional recovery of the hemiplegic upper limb.

Methods: Subacute stroke patients underwent repetitive facilitative exercise (n = 11) or conventional rehabilitation (n = 8) for 4 weeks. We investigated spasticity and functional recovery in a hemiplegic upper limb retrospectively. The MAS, F-wave, Fugl-Meyer Assessment (FMA), and the Action Research Arm Test (ARAT) were assessed immediately before and after the 4-week session.

Results: Repetitive facilitative exercise did not change the MAS and decreased F persistence and the F amplitude ratio, and improved both the FMA and the ARAT for the affected upper limb. The reduction of F-wave parameters was not correlated with the improvements in the FMA and ARAT in the repetitive facilitative exercise group. Conventional rehabilitation had no effect on the MAS, F-wave parameters, FMA, or the ARAT.

Conclusions: Repetitive facilitative exercise decreases spinal motoneuron excitability and promotes functional recovery. However, there was no correlation between the change in spinal motoneuron excitability and the improvement of upper-limb function. The present results suggest that repetitive facilitative exercise is useful for treating spasticity in the subacute phase of stroke.

Keywords: F-wave; Repetitive facilitative exercise; spasticity; stroke.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity*
  • Motor Skills*
  • Muscle Spasticity / diagnosis
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / therapy*
  • Muscle, Skeletal / innervation*
  • Paresis / diagnosis
  • Paresis / physiopathology
  • Paresis / therapy*
  • Recovery of Function
  • Retrospective Studies
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*
  • Time Factors
  • Treatment Outcome
  • Upper Extremity