Being cold makes walking with HSP difficult

Posted - February 2018 in Living with HSP - Management & Treatment News

But does warming the legs help?

 

Using heat packs on the legs for 30 minutes improved walking speed by 12% and coordination by 22%, with the gains maintained for at least one hour. The effectiveness of using hot packs to warm cold legs in people with HSP was assessed by walking speed and coordination tests.

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So if you get stiff legs in cold weather, and can feel hot and cold on your legs, try using heat packs, electric blankets or a hot bath for 30 minutes before moving about or walking to improve mobility functioning and performance.

 

Abstract

OBJECTIVES: Cooling of the lower limb in people with Hereditary and Spontaneous Spastic Paraparesis (pwHSSP) has been shown to affect walking speed and neuromuscular impairments. The investigation of practical strategies, which may help to alleviate these problems is important. The potential of superficial heat to improve walking speed has not been explored in pwHSSP. Primary objective was to explore whether the application of superficial heat (hot packs) to lower limbs in pwHSSP improves walking speed. Secondary objective was to explore whether wearing insulation after heating would prolong any benefits.

 

METHODS: A randomised crossover study design with 21 pwHSSP. On two separate occasions two hot packs and an insulating wrap (Neo-G™) were applied for 30minutes to the lower limbs of pwHSSP. On one occasion the insulating wrap was maintained for a further 30minutes and on the other occasion it was removed. Measures of temperature (skin, room and core), walking speed (10 metre timed walk) and co-ordination (foot tap time) were taken at baseline (T1), after 30 mins (T2) and at one hour (T3).

 

RESULTS: All 21 pwHSSP reported increased lower limb stiffness and decreased walking ability when their legs were cold. After thirty minutes of heating, improvements were seen in walking speed (12.2%, P<0.0001, effect size 0.18) and foot tap time (21.5%, P<0.0001, effect size 0.59). Continuing to wear insulation for a further 30minutes gave no additional benefit; with significant improvements in walking speed maintained at one hour (9.9%, P>0.001) in both conditions.

 

CONCLUSIONS: Application of 30minutes superficial heating moderately improved walking speed in pwHSSP with effects maintained at 1hour. The use of hot packs applied to lower limbs should be the focus of further research for the clinical management of pwHSSP who report increased stiffness of limbs in cold weather and do not have sensory deficits.

 

SOURCE: Ann Phys Rehabil Med. 2017 Dec 11. pii: S1877-0657(17)30453-0. doi: 10.1016/j.rehab.2017.12.001. [Epub ahead of print] PMID: 29241713 Copyright © 2017 Elsevier Masson SAS. All rights reserved.

 

Effects of superficial heating and insulation on walking speed in people with hereditary and spontaneous spastic paraparesis: A randomised crossover study.

 

Denton AL1, Hough AD2, Freeman JA2, Marsden JF2.

1 School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, Peninsula Allied Health Centre, Derriford Road, Plymouth, PL6 8BH, United Kingdom. Electronic address: [email protected]

2 School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, Peninsula Allied Health Centre, Derriford Road, Plymouth, PL6 8BH, United Kingdom.

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