Spasticity is one of the complications which frequently follow central nervous system lesion. Spasm in the paralyzed limbs of the patient with spinal cord injury can obviously interfere with activities of daily living. In the case of paresis, voluntary movement is interfered with by spasm. Even in a case where one is dependent on others in the performance of daily activities, spasm can frequently interfere with assistance being given by an other person. To evaluate the clinical value of electrical stimulation for reducing spinal spasticity, electrical stimulation was applied to two patients who have severe spinal spasticity. A four-channel stimulator was used for electrical stimulation. Two patients were stimulated at the bilateral extensor and flexor muscles of knee joints. Spasticity was assessed with both single-session stimulation and prolonged stimulation by clinical methods and a quantitative method. For the quantitative assessment, a pendulum test was used to calculate a relaxation index. The single-session stimulation reduced spasticity (which was assessed both clinically and quantitatively) at least during the daytime if it was given in the morning. The electrical stimulation reduced spasticity not only in lower limbs but also in upper limbs and trunk. The prolonged stimulation reinforced effects of the single-session stimulation clinically, although it did not result in any remarkable change in the relaxation index. For clinical use, instrumentation for assessing spasticity should be simple and inexpensive. The pendulum test, which can measure the knee extensor reflex quantitatively, is extremely suitable for the evaluation of spinal spasticity in the clinical environment, because of its simplicity and reliability. Furthermore, the relaxation index, which can be calculated from the pendulum test, is most suitable for quantitative comparison of spasticity. We concluded that relieving spinal spasticity by electrical stimulation is effective for improving patients' daily activities if stimulation can be applied every morning.
