Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

The use of cold applications in the management of spasticity or paralysis can assist patients to carry out exercise and self-care programs in a more active and functional manner. Techniques for applications of the cold vary somewhat. Moist cold is more effective than a dry ice bag. Heat is not as successful in the treatment of spasticity, nor in reducing the weakness. Cold applications consisting of crushed ice wrapped in wet towels, placed over the spastic groups of muscles for ten minutes, should be followed by exercise to the muscles, or groups of muscles. The favorable effects may last for as long as 12 hours.

Another method of applying the cold is by immersion of an extremity in cold water at 50° F for ten minutes followed by exercise of the part. Injuries and multiple sclerosis have been successfully treated in this way. To immerse a patient in a Hubbard tank at 80° for ten minutes can increase movement and reduce the stretch reflex. Thirty percent of patients so managed derive little or no prolonged benefits from cold therapy, but the remainder received measurable help.

Use fever treatments in an effort to slow down the progress of the disease. Use cold baths for the temporary muscle strengthening obtained in order to prevent muscular atrophy. Since raising the temperature reduces nerve transmission briefly, various body functions such as vision, muscular strength, etc. will often be lost or diminished at specific levels during the rise in body temperature. An interesting phenomenon is that the functions are regained when the temperature is on the way down at a higher temperature than they were lost on the way up. Apparently there is a tolerance or benefit gained by the treatment for temperature elevations. Use a temperature level to 103° to 104° F rectally, 30 to 60 minutes, three to five times weekly for about 20 treatments.