Electrical stimulation to reduce chronic toe-flexor hypertonicity. A case report.
Electrical stimulation reduces hypertonicity, but the mechanism for the effectiveness is not well understood. In this particular case, electrical stimulation to the toe extensors resulted in inhibition of the toe-flexor hypertonicity. This phenomenon may be explained by Sherrington's theory of reciprocal inhibition. Liberson found that electrical stimulation of an agonist is associated with a concomitant inhibition of the antagonist in the healthy individual. I applied Liberson's findings in my treatment of the patient. By facilitating the toe extensors, and thus inhibiting the toe flexors, toe posturing improved considerably and allowed the patient volitionally to control his toes, which, in turn, improved his foot and toe comfort. Stimulation also allowed the patient to assume a plantigrade and forefoot weight-bearing position to improve his gait. This patient benefitted dramatically from the use of electrical stimulation in inhibiting hypertonicity, and I believe this modality may be helpful in other cases dealing with increased muscle tone. The patient will continue to be observed on a regular basis for reassessment of the long-term effects of electrical stimulation on hypertonicity and on the skin at the electrode sites.