Abstract Context: Spasticity is a common complication of upper motor neuron syndrome and, if left untreated, can lead to contracture. In this study, patients with lower limb spastic stiff muscles were injected with hyaluronidase, and the response was assessed compared to similar peers. Aims: The aim of this study was to analyse the differences in Modified Ashworth Score and passive range of movement between groups. Settings and Design: This was a prospective nonrandomized study conducted at a tertiary-level rehabilitation centre. Methods: Patients with lower extremity spastic muscle stiffness due to acquired brain injuries were included. Spasticity was quantified with the Modified Ashworth Score (MAS), popliteal angle and overall passive range of movement. Intervention patients received hyaluronidase in the affected lower extremity muscle groups. After this, patients’ bystanders were taught passive stretching of spastic muscles. The control group received home exercises. Follow-up was done in 2 and 4 weeks. Results: At baseline, there was no significant difference between the groups for the outcome variables. At 2 weeks, MAS (0.4, 95% CI = 2.98–3.63, P = 0.03) and passive range of movement (PRoM) knee (14.0, 95% CI = 49.46–86.59, P = 0.01) and ankle (5.34, 95% CI = 10.05–27.7, P = 0.05) showed significant differences favouring the intervention group. At 4 weeks, knee PRoM (15.33, 95% CI = 53.48–93.23, P < 0.01) and ankle (14.67, 95% CI = 10.14–37.60, P = 0.03) showed significant differences favouring the intervention group. At 50 weeks, ankle PRoM (20.67, 95% CI = 47.62–18.28, P = 0.02) showed significant differences favouring the intervention group. Conclusions: Patients who received intramuscular hyaluronidase had a better range of motion at joints affected by spastic muscle stiffness both early and late.
Sreekumar et al. (Mon,) studied this question.