The Effect of Physiotherapy and Rehabilitation Program on Spasticity Level, Upper Extremity Functions, Activities of Daily Living, and Kinesiophobia in Hemiplegic Patients-Single Group Pretest-Posttest Experimental Study

Objective: Following a stroke, a vascular event occurring in one
hemisphere of the brain leads to paresis and movement restrictions on the contralateral side of the body. This neurological condition is referred to as hemiplegia.
This study aims to evaluate the effects of a physiotherapy and rehabilitation program
on spasticity levels, upper extremity functions, activities of daily living (ADL), and
kinesiophobia in patients with post-stroke hemiplegia. Material and Methods: The
study was designed as a single-group pre-test-post-test experimental study. 20 hemiplegic patients were included in the study. The spasticity levels of the participants
were assessed using the Modified Ashworth Scale, upper extremity functions with
the Fugl-Meyer Upper Extremity Motor Assessment Scale, ADL with the Barthel
Activities of Daily Living Index, and kinesiophobia levels with the Tampa Scale of
Kinesiophobia. The treatment program consisted of 24 sessions, scheduled 3 times
per week. Each session lasted 45 minutes and included Transcutaneous Electrical
Nerve Stimulation, upper and lower extremity range of motion exercises, balance and
coordination exercises, and weight transfer exercises. Evaluations were conducted before and after the treatment. Results: Following the physiotherapy and rehabilitation
program, a significant reduction in spasticity levels was observed in all joints except
the hip joint, as measured by the Modified Ashworth Scale (p<0.05). A significant
improvement was detected in upper extremity motor functions assessed using the
Fugl-Meyer Upper Extremity Motor Assessment Scale (p<0.001). According to the
Barthel Activities of Daily Living Index, there was a notable increase in ADL
(p<0.01). Additionally, kinesiophobia levels, evaluated using the Tampa Scale of Kinesiophobia, significantly decreased (p<0.001). Conclusion: The study has demonstrated that incorporating kinesiophobia management into the treatment program is
crucial for enhancing the effectiveness of rehabilitation following hemiplegia. While
rehabilitation programs aim to improve motor functions, they can also reduce psychological distress, thereby enhancing the patient’s adherence to treatment.