Retrospective chart review of 16 chronic paretic patients (7 W, age 40 ± 8 years, time since lesion 57 ± 35 months) who consecutively participated to a Guided Self-rehabilitation Contract for at least one year (2 years follow-up for 10 of them). By this contract, patients were committed to clinicians to achieve every day a self-stretching program based on self-stretching postures (> 10 mn/muscle/day) and excentric stretching exercises on some selected muscles (“self-stretched” muscles). Each program was specific for each patient. Functional muscle length XV1 (angle of arrest after slow and strong stretch) measured by the clinician at every visit on 5 key muscles of the lower limb (soleus, gastrocnemius, hamstrings, vastus, rectus femoris), they have been selected or not for the self-stretching program, was the main outcome measure. Coefficient of shortening (CS) was calculated CR = (XN–XV1)/XN (XN, normal passive amplitude). After one and two years, muscles has been considered as responders if, from baseline, ΔXV1 > 10° for hamstrings, vastus and rectus femoris, and > 5° for soleus and gastrocnemius.
In retrospect, at baseline, CS for the non-stretched muscles group was 0.12 ± 0.03 (mean ± SD) vs 0.20 ± 0.02 in the self-stretched muscles group (
A customized program of self-stretching daily practiced by chronic paretic patients for at least one year within a Guided Self-rehabilitation Contract might allow a significant functional muscle lengthening. These results need to be confirmed by a prospective controlled study.