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Pain or tightness in joints is also common in spasticity. It is important to seek medical care when spasticity is experienced for the first time with no known cause, the spasticity is worsening and becoming more frequent, pain is experienced due to stiff joints and muscles or the condition is preventing performance of everyday tasks.

Begin by contacting your primary care doctor , who may refer you for further testing or physical therapy. Due to the varying degrees of spasticity, diagnosis may not be so simple.

A physical examination with neurological testing will be done to test for spasticity and the severity of it. Imaging such as magnetic resonance imaging MRI can provide more information on the source of spasticity and the extent of the damage that has caused it.

Fortunately, there are several treatment options for spasticity and patients usually undergo more than one treatment at a time.

The following treatments have been shown to effectively alleviate symptoms and improve quality of daily life. Patients are recommended to follow up with their primary care or specialty doctor regularly to ensure proper treatment of the condition.

Typically, for surgeries such as baclofen pump placement, patients are followed by their neurosurgeon who sees them three months, six months and 12 months post operatively and additionally for medicine dosing appointments and any device-related appointments.

Patient Pages are authored by neurosurgical professionals, with the goal of providing useful information to the public.

Pilitsis specializes in neuromodulation with research interests in treatments for movement disorders and chronic pain.

The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets.

Spastic muscles typically demonstrate a loss of selective movement, including a loss of eccentric control decreased ability to actively lengthen.

While multiple muscles in a limb are usually affected in the upper motor neuron syndrome, there is usually an imbalance of activity, such that there is a stronger pull in one direction, such as into elbow flexion.

Decreasing the degree of this imbalance is a common focus of muscle strengthening programs. Spastic movement disorders also typically feature a loss of stabilisation of an affected limb or the head from the trunk , so a thorough assessment requires this to be analysed as well.

Secondary effects are likely to impact on assessment of spastic muscles. If a muscle has impaired function following an upper motor neuron lesion, other changes such as increased muscle stiffness are likely to affect the feeling of resistance to passive stretch.

Other secondary changes such as loss of muscle fibres following acquired muscle weakness are likely to compound the weakness arising from the upper motor neuron lesion.

In severely affected spastic muscles, there may be marked secondary changes, such as muscle contracture , particularly if management has been delayed or absent.

Treatment should be based on assessment by relevant health professionals. For spastic muscles with mild-to-moderate impairment, exercise should be the mainstay of management, and is likely needed to be prescribed by a Physiatrist Doctor specialized in Rehabilitation medicine , occupational therapist, physical therapist, accredited exercise physiologist AEP or other health professional skilled in neurological rehabilitation.

Muscles with severe spasticity are likely to be more limited in their ability to exercise, and may require help to do this. In spastic cerebral palsy children the main treatment modality of spasticity is conservative in the form of botulinum toxin A injection and various physical therapy modalities such as serial casting, sustained stretching and medical pharmacologic treatment.

Both spasticity and contractures can cause joint subluxations or dislocations and severe gait difficulties. Hip dislocation and ankle equinus deformity are known to arise from muscle spasticity primarily.

Orthopedic surgical reconstruction of the hip is commonly practiced to improve sitting balance, nursing care and relief hip pain.

Alternatively, rehabilitation robotics can be used to provide high volumes of passive or assisted movement, depending on the individual's requirements; [11] this form of therapy can be useful if therapists are at a premium, and has been found effective at reducing spasticity in patients suffering from stroke.

A general treatment guideline can be followed that involves:. Medical interventions may include such medications as baclofen , diazepam , dantrolene , or clonazepam.

Phenol injections can be used, or botulinum toxin [8] [9] [14] injections into the muscle belly, to attempt to dampen the signals between nerve and muscle.

The effectiveness of medications vary between individuals, and vary based on location of the upper motor neuron lesion in the brain or the spinal cord.

Medications are commonly used for spastic movement disorders, but research has not shown functional benefit for some drugs. In spastic CP, selective dorsal rhizotomy has also been used to decrease muscle overactivity.

Incorporating hydrotherapy in the treatment program may help decrease spasm severity, promote functional independence, improve motor recovery and decrease medication required for spasticity, which may help reduce the side effects that are possible with oral drug treatments.

It was found that subjects who received hydrotherapy treatment obtained increased FIM scores and a decreased intake of oral baclofen medication.

The prognosis for those with spastic muscles depends on multiple factors, including the severity of the spasticity and the associated movement disorder, access to specialised and intensive management, and ability of the affected individual to maintain the management plan particularly an exercise program.

Most people with a significant UMN lesion will have ongoing impairment, but most of these will be able to make progress. The most important factor to indicate ability to progress is seeing improvement, but improvement in many spastic movement disorders may not be seen until the affected individual receives help from a specialised team or health professional.

Doublecortin positive cells, similar to stem cells, are extremely adaptable and, when extracted from a brain, cultured and then re-injected in a lesioned area of the same brain, they can help repair and rebuild it.

Historical progression of spasticity and the upper motor neuron lesion on which it is based has progressed considerably in recent decades.

However, the term "spasticity" is still often used interchangeably with "upper motor neuron syndrome" in the clinical settings, and it is not unusual to see patients labeled as "spastic" who actually demonstrate not just spasticity alone, but also an array of upper motor neuron findings.

Research has clearly shown that exercise is beneficial for spastic muscles, [21] even though in the very early days of research it was assumed that strength exercise would increase spasticity.

Also, from at least the s through at least the s, there was a strong focus on other interventions for spastic muscles, particularly stretching and splinting , but the evidence does not support these as effective.

In the case of spastic diplegia there is also a permanent neurosurgical treatment for spasticity, selective dorsal rhizotomy , that directly targets nerves in the spine that cause the spasticity, and destroys them, so that the spasticity cannot be activated at all.

From Wikipedia, the free encyclopedia. For the societal implications of the term when applied as a label for a particular person, see spastic.

For the most common type of spasticity-based neuromuscular disorder, see spastic diplegia. Rymer September Thomas Aug 25, Journal of Applied Physiology.

Disability and Rehabilitation. JBJS Reviews. The Cochrane Database of Systematic Reviews. Journal of Pediatric Orthopedics.

Part B. Rehabilitation robotics from past to present: A historical perspective. Stefanov Eds. Berlin: Springer-Verlag. Automatic Robots. Physical Rehabilitation.

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