Spasticity

Spasticity is a physiological consequence of damage to the brain or spinal cord and typically occurs in conditions such as stroke), head trauma, multiple sclerosis, cerebral palsy, and others. Abnormal muscle contraction cause the spastic limbs to lose flexibility, causing pain and mobility problems for sufferers Learn the characteristics and causes of the condition, methods of diagnosis and the various treatment options available.

 
Treatment is not always called for. However, if treatment is indicated, the therapeutic strategy is based on a personalized program of goals:

  • to improve motor function (gestural or walking);
  • to relieve pain;
  • to improve nursing (all aspects of nursing care provided to the patient)
  • To prevent deterioration.

There are several treatment options available:

  • Physiotherapy: is vital, even with oral medication or surgical treatment. Physiotherapy reduces spasticity and teaches patients how best to use their remaining capacity. Stretching exercises improve the range of movement and prevent sometimes painful muscle retraction and contractures.
  • Splints and orthoses: these an also be used, and are prescribed by an orthopedic specialist, neurologist or rehabilitation specialist. These rigid devices help to maintain a spastic limb in a fixed position.
  • Botulinum toxin Type A injection: acts at the neuromuscular junction of the target muscle to inhibit acetylcholine (a neurotransmitter) release and reduce muscular contractions.
  • Drug treatments: generally prescribed when spasticity is more generalised, treatment with oral medication is based on muscle relaxants, such as baclofen, dantrolene, tizanidine and benzodiazepines.. Intrathecal baclofen can be used to manage severe spasticity in patients with cerebral palsy or spinal cord injury post-trauma or secondary to multiple sclerosis where patients were unresponsive to oral administration or effective doses produce central nervous system side-effects.
  • Surgery: can be an option if the other treatments are ineffective.

Spasticity develops gradually

Rigorous clinical analysis is required to diagnose spasticity

Treatment is not always called for

Sources :

RCP national guidelines, « Spasticity in adults : management using botulinum toxin » Jan 2009
Bandi, S. & Ward A.B. http://sphhp.buffalo.edu/content/sphhp/rehabilitation-science/research-and-facilities/funded-research-archive/center-for-international-rehab-research-info-exchange/_jcr_content/par/download/file.res/pdf.zip Last accessed 18/07/2017
Intrathecal baclofen https://www.medicines.org.uk/emc/medicine/1295 Last accessed 18/07/2017

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Date of preparation January 2018 / ALL-UK-000455