Year: 2026 | Month: July-September | Volume: 11 | Issue: 3 | Pages: 271-281
DOI: https://doi.org/10.52403/gijhsr.20260330
Effects of Combined Transcutaneous Electrical Nerve Stimulation and Cryotherapy on Upper Limb Spasticity in Adults with Chronic Stroke
Shivanshu Kaushik1, Mansi Kaushik2, Anshu Chandra2
1Assistant Professor, Indian Institute of Health and Technology Deoband, Saharanpur 247554, Uttar Pradesh, India
2Research Scholar, Department of Sports Science, Punjabi University, Patiala 147002, Punjab, India.
Corresponding Author: Anshu Chandra
ABSTRACT
Background: Upper limb spasticity is one of the most common motor impairments following stroke and significantly compromises functional independence, movement quality, and quality of life. Conventional physiotherapy often incorporates adjunctive modalities to reduce muscle hypertonia; however, evidence regarding the combined therapeutic effects of Transcutaneous Electrical Nerve Stimulation (TENS) and cryotherapy remains limited, particularly in individuals with chronic stroke.
Objective: This study aimed to evaluate the effects of combined Transcutaneous Electrical Nerve Stimulation (TENS) and cryotherapy on upper limb spasticity in adults with chronic stroke.
Methods: A single-group pre–post experimental study was conducted among fifteen adults with chronic stroke (13 males and 2 females) aged 51–69 years presenting with upper limb spasticity. Participants met predefined inclusion criteria, including Modified Ashworth Scale (MAS) grades 1–3 and the ability to ambulate with or without assistance. The intervention consisted of high-frequency TENS (100 Hz; pulse width 200 μs) administered to the affected upper limb, followed by 20 minutes of cryotherapy using crushed ice packs applied over the spastic musculature. Treatment sessions were conducted six days per week for four weeks. Spasticity was assessed before and after the intervention using the Modified Ashworth Scale (MAS). Pre- and post-intervention scores were compared using a paired-samples t-test, with statistical significance established at p < 0.05.
Results: Following the four-week intervention, participants demonstrated a significant reduction in upper limb spasticity compared with baseline measurements. Improvements were reflected by lower Modified Ashworth Scale scores after treatment, indicating decreased muscle hypertonia and enhanced voluntary motor control of the wrist and hand. Statistical analysis confirmed that the combined intervention produced a significant therapeutic effect (p < 0.05).
Conclusion: The findings suggest that combined TENS and cryotherapy may serve as an effective adjunctive rehabilitation strategy for reducing upper limb spasticity in adults with chronic stroke. The intervention appears to facilitate improved neuromuscular regulation and voluntary motor performance. Although the present findings are encouraging, larger randomized controlled trials with extended follow-up periods and functional outcome measures are recommended to confirm long-term clinical effectiveness.
Keywords: Stroke, Chronic Stroke, Upper Limb Spasticity, Transcutaneous Electrical Nerve Stimulation, TENS, Cryotherapy, Neurorehabilitation, Modified Ashworth Scale, Physical Therapy, Experimental Study.