In O’Sullivan, under multiple sclerosis, treatment for spasticity includes maintained stretch held for 30 mins to 3 hrs which can decrease stretch reflex activity. Won’t that cause fatigue and in turn results in relapsing of the condition?

Prolonged Muscle Stretching (PMS) is a technique often applied by clinical PTs in the management of spasticity of various etiology. In most cases, it is a passive procedure that does not involve physical exertion by the patient i.e. the force producing the stretch is provided by the therapist (The patient’s muscles are not actively working against resistance). In other cases, a traction device utilizing sand bags of various weights is used. As a result, there is minimal tendency for patient fatigue.

The frequency is the periodicity of the stretch which can vary from a single session to daily sessions over several weeks. The frequency and consistency (or otherwise) of the stretching/treatment sessions is a better determinant of relapse occurring rather than the length of a single PMS session.