High-tone power therapy plus physical therapy improves spasticity and gait speed in chronic stroke patients

INTRODUCTION: The effective management of spasticity and improving functional mobility continue to pose challenges to physiotherapy management. This research designed to compare the impact of combining high-tone power therapy with physical therapy program versus physical therapy alone on lower limb spasticity and gait speed in chronic (≥ 6 months) stroke, non-obese, middle-aged male patients. MATERIAL AND METHODS: Thirty-four eligible male patients were randomly assigned to 2 groups equal in number: treatment (G1) and control (G2). The subjects in the treatment group received 30 min of real high-tone power therapy stimulation (HTT), followed by 30 min of selected physical therapy program. The control group received only 1 h of selected physical therapy program (3 days per week for 3 months). Spasticity was measured by Modified Ashworth scale (MAS) and Neurophysiological studies (H/M ratio), self-selected comfortable walking speed (SSCWS) and fastest walking speed (FWS) were measured by 10 m walk test (10 MWT) and assessed for both groups at baseline and after intervention. RESULTS: Post treatment, between-group analysis showed that G1 (HTT + physical therapy) demonstrated significant improvements (p < 0.05) compared to G2 (physical therapy alone) in spasticity (MAS: p = 0.017, H/M ratio: p = 0.0001) and gait speed (10MWT-SSCWS: p = 0.0001, 10MWT-FWS: p = 0.0001). Within group analysis indicated that there was no significant decrease (p > 0.05) in MAS (p = 0.589), H/M ratio (p = 0.806), 10MWT-SSCWD (p = 0.136), and 10MWT-FWS (p = 0.287) within the control group (G2). CONCLUSIONS: The combined program of high-tone power therapy (HTT) for 30 min followed by 30 min of physical therapy program has superior effects in improving spasticity and gait speed in non-obese, middle-aged male patients with chronic stroke compared to the physical therapy program alone. While these findings support the potential value of the combined approach, the difference in the therapeutic program between the 2 groups and the absence of a sham control group prevent determining the specific contribution of the HTT component. Future dose-matched and sham-controlled trials are required to clarify the independent therapeutic effect of HTT. TRIAL REGISTRATION: Prospectively registered with ClinicalTrials.gov as Registry ID: (NCT06562530).