Spasticity in neurological diseases – principles of treatment Review article
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Published:
Jun 30, 2013
Keywords:
spasticity, baclofen, tolperison, botulinum toxin, neurolysis, physiotherapy
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Abstract
This paper discusses extensively the modern principles of management of patients with spasticity based on pathophysiological basis. Spasticity is a symptom of many neurological diseases: stroke, multiple sclerosis, brain and spinal injuries, cerebral palsy. The proper treatment of spasticity is possible after a thorough clinical evaluation. At present are used nonpharmacological: physiotherapy, and in select cases, surgery and drug therapy: general (tinazidina, baclofen, diazepam, tolperizon, dantrolene) and local (ethanol, phenol, botulinum toxin type A). The choice of therapy due to the severity of spasticity, the underlying disease, treatment options. Therapy should be individualized as much as possible and adapted to the needs and expectations of the patient. Successfully treated spasticity contributes to significant improvements in patient function and quality of life.
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Zaborski, J. (2013). Spasticity in neurological diseases – principles of treatment. Medycyna Faktow (J EBM), 6(2(19), 57-62. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2415
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References
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2. Yeargin-Allsopp M., van Naarden Braun K., Doernberg N.S., Benedict R.E., Kirby R.S., Durkin M.S.: Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multisite collaboration. Pediatrics 2008; 121: 547-54.
3. Barnes M.P., Kent R.M., Semlyen J.K., McMullen K.M.: Spasticity in multiple sclerosis. Neurorehabil. Neural. Repair. 2003; 17: 66-70.
4. Watkins C.L., Leathley M.J., Gregson J.M., Moore A.P., Smith T.L., Sharma A.K.: Prevalence of spasticity post stroke. Clin. Rehabil. 2002; 16: 515-22.
5. Wichers M.J., Odding E., Stam H.J., van Nieuwenhuizen O.: Clinical presentation, associated disorders and aetiological moments in Cerebral Palsy: a Dutch population-based study. Disabil. Rehabil. 2005; 27: 583-9.
6. Lance J.W.: What is spasticity? Lancet 1990; 335: 606.
7. Welmer A.K., von Arbin M., Widen Holmqvist L., Sommerfeld D.K.: Spasticity and its association with functioning and health-related quality of life 18 months after stroke. Cerebrovasc. Dis. 2006; 21: 247-53.
8. Thompson F.J., Parmer R., Reier P.J., Wang D.C., Bose P.: Scientific basis of spasticity: insights from a laboratory model. J. Child. Neurol. 2001; 16: 2-9.
9. Mayer N.H.: Clinicophysiologic concepts of spasticity and motor dysfunction in adults with an upper motoneuron lesion. Muscle Nerve Suppl. 1997; 6: S1-13.
10. Mayer N.H., Esquenazi A., Childers M.K.: Common patterns of clinical motor dysfunction. Muscle Nerve Suppl. 1997; 6: S21-35.
11. Pierson S.H.: Outcome measures in spasticity management. Muscle Nerve Suppl. 1997; 6: S36-60.
12. Haugh A.B., Pandyan A.D., Johnson G.R.: A systematic review of the Tardieu Scale for the measurement of spasticity. Disabil. Rehabil. 2006; 28: 899-907.
13. Hsieh J.T., Wolfe D.L., Miller W.C., Curt A.: Spasticity outcome measures in spinal cord injury: psychometric properties and clinical utility. Spinal Cord 2008; 46: 86-95.
14. Hsieh Y.W., Hsueh I.P., Chou Y.T., Sheu C.F., Hsieh C.L., Kwakkel G.: Development and validation of a short form of the Fugl-Meyer motor scale in patients with stroke. Stroke 2007; 38: 3052-4.
15. Esquenazi A., Mayer N.H.: Instrumented assessment of muscle overactivity and spasticity with dynamic polyelectromyographic and motion analysis for treatment planning. Am. J. Phys. Med. Rehabil. 2004; 83: S19-29.
16. Cooper A., Musa I.M., van Deursen R., Wiles C.M.: Electromyography characterization of stretch responses in hemiparetic stroke patients and their relationship with the Modified Ashworth scale. Clin. Rehabil. 2005; 19: 760-6.
17. van der Salm A., Veltink P.H., Hermens H.J., Ijzerman M.J., Nene A.V.: Development of a new method for objective assessment of spasticity using full range passive movements. Arch. Phys. Med. Rehabil. 2005; 86: 1991-7.
18. Kim D.Y., Park C.I., Chon J.S., Ohn S.H., Park T.H., Bang I.K.: Biomechanical assessment with electromyography of post-stroke ankle plantar flexor spasticity. Yonsei Med. J. 2005; 46: 546-54.
19. Lockley L.: The role of the specialist physiotherapist in the management of spasticity. Way Ahead 2004; 7: 6-7.
20. Goldstein E.M.: Spasticity management: an overview. J. Child. Neurol. 2001; 16: 16-23.
21. Boop F.A., Woo R., Maria B.L.: Consensus statement on the surgical management of spasticity related to cerebral palsy. J. Child. Neurol. 2001; 16: 68-9.
22. Gracies J.M., Nance P., Elovic E. et al.: Traditional pharmacological treatments for spasticity. Part II: General and regional treatments. Muscle Nerve Suppl. 1997; 6: S92-120.
23. Gracies J.M., Elovic E., McGuire J. et al.: Traditional pharmacological treatments for spasticity. Part I: Local treatments. Muscle Nerve Suppl. 1997; 6: S61-91.
24. Tilton A.H.: Injectable neuromuscular blockade in the treatment of spasticity and movement disorders. J. Child. Neurol. 2003; 18(Suppl. 1): S50-66.
25. van Kuijk A.A., Geurts A.C.H., Bevaart B.J.W., van Limbeek J.: Treatment of upper extremity spasticity in stroke patients by focal neuronal or neuromuscular blockade: a systematic review of the literature. J. Rehab. Med. 2002; 34: 51.
26. Sheean G.: Botulinum toxin treatment of adult spasticity: a benefit-risk assessment. Drug Saf. 2006; 29: 31-48.
27. McGuire J.R.: Effective use of chemodenervation and chemical neurolysis in the management of poststroke spasticity. Top. Stroke Rehabil. 2001; 8: 47.