Management of painful spasticity
Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen in Clinical Pain Management, 2008
Muscle spasm is a particular feature of spinal (including brain stem) origin spasticity as described above under Pathophysiology of spasticity.10, 11 Mass extensor spasms affect lower limbs, trunk and, in higher lesions, the upper limbs (Figure 33.1). In severe spasticity, flexor spasms of the lower limbs also occur (Figure 33.2) and may be associated with pain in those people with preserved sensation. These sorts of spasms frequently occur in people with poor or absent sensation where the typical muscle pain cannot be expressed. It is often the spasms themselves rather than the pain that require treatment.12 Even so, pain not infrequently accompanies these spasms and can be very severe. Chronic muscle spasticity will frequently be felt as tightness or discomfort or pain, even in the absence of spasms.
Patient Information – Managing Your Spasticity and Spasms
Valerie L. Stevenson, Louise Jarrett in Spasticity Management, 2016
Spasticity can be described as involuntary muscle stiffness. It can range from mild to severe and change over time, often from day to day or hour to hour. Symptoms can be unpleasant, but sometimes spasticity can be helpful; if a person’s legs are very weak, the stiffness spasticity causes may actually help in transferring from bed to chair or even in walking. The key to successful management of spasticity is the individual, who needs to be aware of the management strategies that they can incorporate into daily life.
Clinical Management of Spasticity and Contractures in Multiple Sclerosis
Anand D. Pandyan, Hermie J. Hermens, Bernard A. Conway in Neurological Rehabilitation, 2018
The first study of the effects of TENS in MS that considered spasticity as an outcome measure, in this case the primary outcome measure, was a small pilot study of 10 people with MS (Armutlu et al. 2003). This study used muscle electromyography to assess spasticity along with the MAS. The study reported that 20 minutes of TENS per day for 4 weeks significantly reduced lower limb spasticity in people with MS, although there was no control group in this study.
Effects of neurorehabilitation with and without dry needling technique on muscle thickness, reflex torque, spasticity and functional performance in chronic ischemic stroke patients with spastic upper extremity muscles: a blinded randomized sham-controlled clinical trial
Published in Disability and Rehabilitation, 2023
Fatemeh Panahi, Samaneh Ebrahimi, Zahra Rojhani-Shirazi, Alireaza Shakibafard, Ladan Hemmati
Spasticity occurs in terms of the imbalance between inhibitory and excitatory mechanisms due to lateral reticulospinal tract damage [4–7]. Although the primary cause of spasticity is brain pathways damage, the resulting morphological and biomechanical changes in the affected muscles can exacerbate it over time [8–10]. electromyography (EMG) studies showed that the most increase in muscle tone due to reflex increment, peaks in one to three months following stroke. After three months, continuing of muscle contraction could be more a result of intrinsic changes of the muscles [11–13]. The affected muscle fibers undergo continuous concentric contraction, resulting in a decrease in their length and an increase in their thickness as well [14,15]. Therefore, the evaluation of spastic muscle architecture, such as muscle thickness as well as the antagonist muscle torque produced around the relevant joint, may be very useful to provide reliable objective data for assessment and treatment protocols [16–18].
The impact of upper limb spasticity-correcting surgery on the everyday life of patients with disabling spasticity: a qualitative analysis
Published in Disability and Rehabilitation, 2022
Therese Ramström, Lina Bunketorp-Käll, Johanna Wangdell
Options for managing spasticity include nonpharmacological treatments, such as muscle stretching, positioning orthoses, and muscle strength training; pharmacological treatments; and surgical interventions [17–19]. Little qualitative research has been done to understand how people with upper limb (UL) spasticity due to a neurological diagnosis experience spasticity treatment. Qualitative studies of patients’ perspectives on living with spasticity have shown complex and diverse effects, ranging from body function impairments to employment and relationship problems, long-term consequences for life goals, and fears for the future [14,20–22]. The varied and individual experience of spasticity suggests that the use of fixed criteria to assess the results of treatment will fail to capture the variety of lived experience, and some perspectives might be missed.
A pilot study of the impact of the electro-suit Mollii® on body functions, activity, and participation in children with cerebral palsy
Published in Assistive Technology, 2022
Camilla Flodström, Sari-Anne Viklund Axelsson, Birgitta Nordström
There are various ways to treat spasticity, and the physiotherapeutic treatment can be training, stretching, mechanical loading and/or orthosis (Glickman et al., 2010), sometimes in combination with pharmacological treatment such as baclofen, botulinum neurotoxin (BoNT), or selective dorsal rhizotomy (Tedroff, 2013). Electrical stimulation has also been used for reducing spasticity (Bakheit, 2012, Moll et al., 2017) as well as increasing muscle function for patients with reduced volitional activity (Wright et al., 2012). According to P. Rosenbaum and Stewart (2004), the components (activity, participation, body functions and structures, personal and environmental factors) are linked to one another. Therefore, when treating body structures, body functions would be affected, which in turn is expected to have a positive impact on activity and participation.
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