Comparison of Active Stretching versus Passive Stretching in Reducing Spasticity-Associated Soreness and Stiffness in Adults with Chronic Stroke: A Randomized Controlled Trial

Abstract

Background: Spasticity following stroke may contribute to muscle stiffness, soreness, restricted range of motion, and impaired functional performance. Although stretching is commonly used in stroke rehabilitation, evidence comparing active and passive stretching for spasticity-associated soreness and stiffness remains limited. Objective: To compare the effects of active versus passive stretching on spasticity, soreness, and stiffness in adults with chronic stroke. Methodology: This randomized controlled trial included 36 adults with chronic stroke, aged 45-65 years, allocated to active stretching (n=18) or passive stretching (n=18). Both groups received supervised interventions three times weekly for four weeks. Spasticity, soreness, and stiffness were assessed before and after treatment using the Modified Ashworth Scale, Numeric Pain Rating Scale, and numerical stiffness rating scale, respectively. Results: Both groups demonstrated improvements in spasticity, soreness, and stiffness. The active stretching group showed a greater reduction in soreness (mean change = 2.11±0.76) than the passive stretching group (1.44±0.68). Stiffness also decreased more with active stretching (2.28±0.81) than with passive stretching (1.61±0.73). Improvements in Modified Ashworth Scale scores additionally favored active stretching. However, the authors did not provide statistical significance or confidence intervals for between-group differences. Conclusion: Both stretching approaches may improve spasticity-associated symptoms in adults with chronic stroke, with potentially greater benefits from active stretching. Further adequately powered clinical trials are needed to confirm their comparative effectiveness.