Rehabilitation medicine: 3. Management of adult spasticity

Satkunam, Lalith E.
November 2003
CMAJ: Canadian Medical Association Journal;11/25/2003, Vol. 169 Issue 11, p1173
Academic Journal
SPASTICITY REFERS TO AN ABNORMAL, velocity-dependent (i.e., how fast the joint is moved through its range) increase in muscle tone resulting from interruption of the neural circuitry regulating the muscles and is a common complication of cerebral palsy, brain injuries, spinal cord injuries, multiple sclerosis and stroke. The muscle stretch reflex is thought to play an important role in spasticity generation. Spasticity can have a significant detrimental effect on daily functions, such as feeding, dressing, hygiene, bladder and bowel control, and mobility; patients' need for support can also influence the cost of care. Thus, managing these patients appropriately or referring them to those with expertise in this area is important. In this article, I review the pathophysiology of spasticity and the evaluation and management of adult patients with the condition. Two hypothetical cases are presented to illustrate the management of spasticity.


Related Articles

  • The functional significance of cortical reorganization and the parallel development of CI therapy. Taub, Edward; Uswatte, Gitendra; Mark, Victor W. // Frontiers in Human Neuroscience;Jun2014, Vol. 8, p1 

    For the nineteenth and the better part of the twentieth centuries two correlative beliefs were strongly held by almost all neuroscientists and practitioners in the field of neurorehabilitation. The first was that after maturity the adult CNS was hardwired and fixed, and second that in the...

  • Obturator neurolysis using 65% alcohol for adductor muscle spasticity. Ghai, Anju; Singh Sangwan, Sukhbir; Hooda, Sarla; Kiran, Shashi; Garg, Nidhi // Saudi Journal of Anaesthesia;Jul2012, Vol. 6 Issue 3, p282 

    Spasticity is motor alteration characterized by muscle hypertonia and hyperreflexia. It is an important complication of spinal cord injury, traumatic brain injury, cerebral palsy, and multiple sclerosis. If uncorrected, fibrosis and eventually bony deformity lock the joint into a fixed...

  • How many people would benefit from a smart wheelchair? Simpson, Richard C.; LoPresti, Edmund F.; Cooper, Rory A. // Journal of Rehabilitation Research & Development;2008, Vol. 45 Issue 1, p53 

    Independent mobility is important, but some wheelchair users find operating existing manual or powered wheelchairs difficult or impossible. Challenges to safe, independent wheelchair use can result from various overlapping physical, perceptual, or cognitive symptoms of diagnoses such as spinal...

  • Botulinum Toxin as a Neuro-Relearning Drug Tool in Motor Paralytic Disorders. Krishnan, R. Venkata // Current Drug Therapy;May2009, Vol. 4 Issue 2, p101 

    The clinical use of Botulinum toxin (BoTx) in motor paralytic disorders until now is limited to spasticity relief in isolated spastic muscle/s. This paper advocates that BoTx should be used as a neuro-relearning tool that can significantly improve recovery in motor paralytic disorders. BoTx...

  • MOTNJE FUNKCIJE ÄŒUTIL IN FUNKCIONIRANJE OSEB Z MULTIPLO SKLEROZO. Papež, Breda Jesenšek // Rehabilitation / Rehabilitacija;2012 Supplement 1, Vol. 11, p111 

    Multiple sclerosis (MS) is a disease which progressively injures the nerves of the brain and the spinal cord, reflected by alterations of virtually every sensory or motor function in the body. It is the most common cause of nontraumatic disability affecting young adults. The cause of multiple...

  • Acute mountain sickness in disability and adaptive sports: Preliminary data. Dicianno, Brad E.; Aguila, Eric D.; Cooper, Rory A.; Pasquina, Paul F.; Clark, Mary J.; Collins, Diane M.; Fitzgerald, Shirley G.; Wichman, Todd A. // Journal of Rehabilitation Research & Development;2008, Vol. 45 Issue 4, p479 

    Acute mountain sickness (AMS) is a frequent complication for military personnel, veterans, athletes, and travelers at high altitudes. Symptoms may occur in individuals with less cerebrospinal fluid volume and less ability to accommodate increased brain volume. No studies on AMS exist in...

  • Soluble Axoplasm Enriched from Injured CNS Axons Reveals the Early Modulation of the Actin Cytoskeleton. Garland, Patrick; Broom, Lucy J.; Quraishe, Shmma; Dalton, Paul D.; Skipp, Paul; Newman, Tracey A.; Perry, V. Hugh // PLoS ONE;Oct2012, Vol. 7 Issue 10, Special section p1 

    Axon injury and degeneration is a common consequence of diverse neurological conditions including multiple sclerosis, traumatic brain injury and spinal cord injury. The molecular events underlying axon degeneration are poorly understood. We have developed a novel method to enrich for axoplasm...

  • Spasticity outcome measures in spinal cord injury: psychometric properties and clinical utility. Hsieh, J. T. C.; Wolfe, D. L.; Miller, W. C.; Curt, A. // Spinal Cord;Feb2008, Vol. 46 Issue 2, p86 

    Study design:Comprehensive review and systematic analyses.Objectives:Assess published psychometric evidence for spinal cord injury (SCI) spasticity outcome measures. Considerations about the influence of spasticity on function have also been identified to understand treatment effects and guide...

  • FLICKS.  // Abilities;Fall2012, Issue 91, p8 

    The article presents review of films including "Beauty School," directed by Adam Grant Warren, "The Intouchables," directed by Olivier Nakache and Eric Toledano, and "The Big Picture: Rethinking Dyslexia," directed by James Redford.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics