Alcohol Neurolysis Of Tibial Nerve Versus Transcutaneous Electrical Nerve Stimulation And Physical Therapy In Ankle - Foot Spasticity Management (Clinical – Electrophysiological study)

1- To evaluate the effectiveness of using ethyl alcohol 100% for tibial nerve neurolysis in the management of ankle planter flexor spasticity by both clinical and electrophysiological methods.2- To determine the efficacy of TENS application on the tibial nerves of the spastic limb. This was evaluated by both clinical and electrophysiological methods.3- To compare between both of them and other conventional physical therapy in the management of ankle-foot spasticity by both clinical and electrophysiological methods.• This study included 36 patients with ankle-foot spasticity, their ages ranged from 30-70 years with a mean value of (51.5 ± 15.5) years.• The patients were randomly classified into 3 different groups according to the line of treatment:Group (I): included 12 patients were injected at the tibial nerves of their spastic limbs by 100% ethyl alcohol in 1% lidocain. Also these patients were subjected to a conventional physical therapy program which was done at a rate of 1session\ every other day for 1 month.Group (II): included 12 patients, TENS were applied to the tibial nerves of their spastic limbs at frequency of 100 Hz and duration of 100 m/s. Each session last 15 min and applied at a rate of 1 session\every other day for 1 month. Also these patients were subjected to the same previous physical therapy program.Group (III): included 12 patients were subjected only to the same previous physical therapy program for 1 month which was done at a rate of 1 session\ every other day.• Outcome measures: