The Effectiveness of High-intensity Laser Therapy on Plantar Flexor Muscle Spasticity in Stroke Patients

Prior treatment

• Patients who have undergone antispastic surgery in the treatment area in the past 6 months
• Patients with recent changes in oral antispastic medication use in the past 6 months

Other illness

• Patients with acute inflammation or active infection in the treatment area
• Patients with a history of ankle joint contracture, fracture, neoplasm, vascular disease, etc.
• Patients with other neurological (Parkinson's disease, epilepsy, meningitis, cerebellar disease, vertigo, dizziness, polyneuropathy, etc.) or musculoskeletal (severe back pain, knee problems) diseases that could affect balance performance other than stroke

Other

• Patients with severe cardiovascular or musculoskeletal problems that impair walking (e.g., fixed ankle contracture)
• Patients who have been treated for spasticity with botulinum toxin, phenol, or alcohol injections in the past 6 months
• Patients with severe vision, hearing, and language problems
• Patients who do not consent to participate in the study

• Patients aged ≥ 18 and ≤ 75 years
• Patients experiencing their first stroke (onset \> 3 months)
• Patients with ankle plantar flexor muscle spasticity with a Modified Ashworth Scale (MAS) score ≥ 1 and \< 4
• Lower extremity Brunnstrom staging ≥ 3
• Patients describing pain complaints in the affected leg as VAS \> 3.
• Patients who can stand independently or with supervision for at least 2 minutes for measurements taken while standing
• Patients who can walk independently or with/without assistive devices for at least 10 meters for measurements taken while walking
• Patients with cognitive abilities sufficient to understand the study instructions (Mini-Mental State Examination score \> 23)
• Patients with stable medical and psychological conditions
• Patients willing to participate in the study