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The effect of Trager therapy on the level of evoked stretch responses in patients with Parkinson's disease and rigidity

2002; Elsevier BV; Volume: 25; Issue: 7 Linguagem: Inglês

10.1067/mmt.2002.126469

1532-6586

Christian Duval, Denis L. J. Lafontaine, Jacques Hébert, Alain Leroux, Michel Panisset, Jean P. Boucher,

Transcranial Magnetic Stimulation Studies

Objective: To quantify changes of evoked stretch responses (ESR) in the most rigid arm of patients with Parkinson's disease (PD) after Trager therapy. Methods: Gentle rocking motion associated with this type of manual therapy was imparted to the upper limbs and body of 30 patients for 20 minutes. A pretest and 2 posttests (at 1 and 11 minutes after the treatment, respectively) were performed, consisting of electromyographic (EMG) recordings of the flexor carpi radialis and extensor digitorum communis while the patient's wrist was passively flexed and extended with an amplitude of 60° and a frequency of 1 Hz. Patients received the treatment on the most rigid side of their bodies (ipsi-group) or on the contralateral side (contra-group). Half of patients in each group received the treatment while lying supine on a massage table (ipsi- and contra-supine) or sitting in a chair (ipsi- and contra-sitting). Results: In general, the level of ESR were reduced by 36% immediately after treatment and remained 32% lower than pretest values 11 minutes after treatment (F = 41.45, P < .05). Patients who received the treatment lying supine benefited from a 42% reduction of ESR (F = 4.07, P < .05). The side on which the treatment was performed did not significantly influence the outcome of the treatment (F = 0.50, P > .05). However, post hoc analysis of the triple interaction (test × side × position) indicated that the sitting position was much less efficient for sustained contralateral effect (P > .05). Conclusions: Results from the present study strongly suggest that it is possible to modify the level of ESR by using Trager therapy. This stretch reflex inhibition may induce a reduction of the muscle rigidity seen in these patients. The present results may eventually lead to the development of a specific complementary therapy for patients with Parkinson's disease and rigidity. (J Manipulative Physiol Ther 2002;25:455-64)