Below you will find the most frequently asked questions (FAQs). We will be udpating this section periodically.
What are the risk factors for developing spasticity?
There are several factors that can exacerbate pre-existing spasticity, like pain, emotional tensions (joy, anger, grief), urination or bowel movement, infections, constrictive clothing, tight shoes, ingrown nails, inflammation, skin injuries, thromboses, and fractures.
After a stroke, high-grade paralysis and sensory disturbances are risk factors for the development of spasticity.
Why did I develop spasticity?
Spasticity happens when there is damage to the area of your brain that controls your muscles. If you have spasticity you will have increased muscle tone. Muscle tone is the resistance or tension in your muscles, and it is what enables us to hold our bodies in a particular position. An increased muscle tone can make it difficult to move your limbs.
source: Stroke Association (2012) Pain after stroke
What is spasticity?
Spasticity is one of several clinical features/motor behaviors that may result following damage to the part of the brain or spinal cord involved in controlling voluntary movement. Collectively, these features are known as the upper motor neuron (UMN) syndrome. Spasticity is associated with a pathologically increased muscle tone. This creates stiffness and resistance to passive movement (the word ‘spasm’ originates from the Greek word, ‘spasmos’, which means to drag or pull). This change in muscle tone may increase the disability related to the disease at the origin of spasticity.
Can spasticity affect libido?
Yes, Patients with increased spasticity often report a decreasing libido. In particular painful muscle stiffness can reduce sexual desire.
Whether there is a difference between right and left hemispheric lesions has not yet been clarified. Studies in regard to laterality are currently not consistent. 4
4 Park J-H. et al. Stroke and sexual dysfunction – A narrative review. Journ. J Neurol Sci 2015; 350:8. Epub: 2015/02/07.
Is it normal to experience increased spasticity during sexual intercourse?
Yes, many patients develop increased spasticity during sexual intercourse and especially during orgasm.³ The human body experiences an exceptional hormonal situation in the sense of a stress reaction, and the jerking movements increase the internal tension of the skeletal muscles. Exaggerated expectations and pressure to “perform” come on top. All these parameters promote increased spasticity.
However, even if the sexual act has once been affected by increased spasticity, it does not necessarily have to happen again next time. Increased spasticity during sexual intercourse can often be overcome or at least reduced by small adjustments. These can include various sensual stimuli such as dimmed light, scented candles, relaxing music, as well as changes of location and position (bathtub, swing systems) or massages. Simple aids such as support pillows, rolled up towels or the partner’s hands can help to relieve muscular tension in parts of the body.
3 Park J-H. et al. Stroke and sexual dysfunction – A narrative review. Journ. J Neurol Sci 2015; 350:7-13. Epub: 2015/02/07.
What’s the best way to explain my condition to family members so they understand?
Muscle tone is a state of tension that is maintained continuously – minimally even when relaxed – and which increases in resistance to passive stretch. It helps to maintain posture and decreases during sleep. The stretch reflex is a muscle contraction in response to stretching within the muscle. This reflex, by definition extremely fast exists to allow the muscle to adapt to any kind of muscular tone, to avoid over-stretching , e.g. when need to adapt to a brutal change of the ground.
In spasticity, the muscle tone is abnormally increased (muscle hypertonia), and reflexes such as the stretch reflex may persist for too long and may be too strong (hyperactive reflexes). These phenomena cause an increased resistance to passive movement (e.g., if someone else tries to move the extremities of the person affected) characterized in the following ways:
- it increases with increasing speed of stretch and varies with the direction of joint movement and/or
- it increases above a patient-specific threshold speed or joint angle
The slower the speed and the smaller the angle when spasticity appears, the more severe it is.
Will spasticity keep me from walking?
Depending on brain and spinal cord damage, spasticity can cause limited mobility of the lower extremities and difficulties in walking. Since each individual is unique, this can only be answered by a doctor on the base of symptoms and findings.
Is spasticity getting worse over time?
It depends. Untreated spasticity is very likely to increase over the years. However, if spasticity is treated consistently with medication and physiotherapy, it can be even reduced over time.
To prevent spasticity from getting worse, therapy should be regularly checked and adjusted
How is spasticity diagnosed and who do you get the diagnosis from?
Diagnosis of spasticity is mainly based on clinical evaluation that should include:
- Clinical history
- Physical examination
- evaluation of stretch reflexes (e.g., deep tendon reflexes, involuntary muscle contractions provoked by stretching the muscle with a tap on the tendon that connects the muscle to a bone)
- passive and active motion
- Function, e.g., toileting, eating, sleeping, dressing, sitting, standing, and walking
A proper assessment of the individual’s clinical and neurological status is critical in developing an effective treatment plan with achievable goals.
Spasticity is diagnosed if the patient shows an increased resistance to passive movements that increases with speed and typical positioning of the limbs, due to increased muscle tone. The diagnosis is not complicated for rehabilitation specialists but unfortunately a lot of other specialists/HCP are not trained and thus don’t recognized the symptoms or when they do so, don’t see the potential benefit of an adapted treatment.
Why does it take so long to identify spasticity in stroke patients?
Spasticity is diagnosed if the patient shows an increased resistance to passive movements that increases with speed and typical positioning of the limbs, due to increased muscle tone. The diagnosis is not complicated for rehabilitation specialists but unfortunately a lot of other specialists/HCP are not trained and thus don’t recognized the symptoms or when they do so, don’t see the potential benefit of an adapted treatment.
I used to take botulinum toxin. Now I have been using electrostimulation and occupational therapy for over 20 years. Spasticity is weaker than before. Can I get fully rid of the spasticity?
Every therapeutic success—no matter by which method—is welcome. However, it is not yet possible to fully cure spasticity. So far, spasticity is considered irreversible today.
There are many people who benefit from functional electrostimulation (often in conjunction with orthoses, tape or injections) and regular therapy. Overall, there is increasing evidence that a combination of different interventions is more effective in alleviating the symptoms associated with spasticity than an isolated form of treatment.
What factors can worsen my spasticity
The triggering factors for spasticity can vary strongly between individuals. Moods, situations or illnesses might intensify spasticity. 5 These can include:
- Temperature changes
- touch
- tight or uncomfortable clothes
- physical tension
- shock, fear
- fatigue
- noise of any kind
- changes of lighting conditions
- emotional and physical stress
- sneezing
- obstipation
- infection
- menstrual cycle
- fever
- pain
- thirst, hunger.
5 Phadke CP et. al Revisiting physiologic and psychologic triggers that increase spasticity. Am J Phys Med Rehabil, 2013. 92(4): p. 357-69.
Does the intensity of spasticity depend on the time of day or the weather?
Many patients report that the strength of their spasticity varies with time of day or weather conditions. Low or very warm outside temperatures, storms, sultriness and cold wet weather increase muscle stiffness in many cases.
If the musculature stiffens towards the evening, it might help to postpone or increase the evening medication. Medication should be regularly checked and adapted anyway.
Many patients with spasticity benefit from keeping a regular daily routine. This means, for example, going to bed and getting up at about the same time every day. Muscle complaints often worsen after a short and sleepless night. Regular rest and recovery periods during the day can reduce muscle cramps caused by overload. Patients with spasticity should also pay attention to proper movement and posture patterns. Physiotherapists can give detailed instructions and recommendations.
Does spasticity affect cognitive abilities?
No, spasticity doesn’t affect cognitive abilities. The pathological increase in muscle tension is caused by damage of the central nervous system (brain and spinal cord), but it only affects the ability to move.
Are there symptoms/appearances which can be confused with spasticity? Are they treated in the same way as spasticity?
Spasticity is the result of a lesion in the central nervous system (brain and spinal cord). Increase of muscle tones can be caused by other reasons, for example by Parkinson´s disease, due to lack of electrolyte (especially calcium, magnesium, sodium), metabolic disorders and by tetanus.
The treatment of increased muscle tone always depends on its cause. For example, in the case of a Parkinson’s disease dopamine is missing. The result is an increased tension in the extensor and flexor muscles. This type of muscle stiffness is treated with drugs that increase the level of dopamine in the brain.
A lack of electrolytes can lead to prolonged, painful muscle twitching, similar to spasticity. Once missing minerals are replaced, the troubles will disappear.
During metabolic diseases (both congenital or acquired), disturbances in anaerobic and aerobic energy metabolism can lead to muscle cramps. The therapeutic goal is to normalize the metabolism.
Tetanus has become rare due to existing vaccinations. These are important because in most cases the infectious disease is fatal. The toxins of the tetanus-triggering bacterium Clostridium tetani attack the muscle-controlling nerve cells and cause severe muscle cramps. There is no real causal treatment so far. The best prevention is immunisation with a tetanus vaccine.
Will my limbs ever go back to normal?
This depends on many factors, such as the cause and the extent of the injury to the brain and spinal cord. Through medical and physiotherapeutic treatments the spastic cramps in the muscles (at least in parts) can be solved. This leads to new mobility, which in many cases is accompanied by a high improvement in the quality of life.
There is a pain at the back of my head since developing spasticity, is the pain caused by spasticity?
Yes, that is possible. Depending on the localization of the spasticity, the surrounding muscle groups are trying to give the body a balance and this can lead to tensions – up to the head.
I can feel my wrists getting stiff, how do I know if I am developing spasticity?
Diagnosis of spasticity is mainly based on clinical evaluation that should include:
- Clinical history
- Physical examination
- evaluation of stretch reflexes (e.g., deep tendon reflexes, involuntary muscle contractions provoked by stretching the muscle with a tap on the tendon that connects the muscle to a bone)
- passive and active motion
- Function, e.g., toileting, eating, sleeping, dressing, sitting, standing, and walking
A proper assessment of the individual’s clinical and neurological status is critical in developing an effective treatment plan with achievable goals.
Spasticity is diagnosed if the patient shows an increased resistance to passive movements that increases with speed and typical positioning of the limbs, due to increased muscle tone. The diagnosis is not complicated for rehabilitation specialists but unfortunately a lot of other specialists/HCP are not trained and thus don’t recognized the symptoms or when they do so, don’t see the potential benefit of an adapted treatment.
The features of spasticity should be assessed individually for each patient, with the focus on three main areas: The clinical pattern of motor function, the patient’s ability to control his or her muscles, and how muscle stiffness and any contractures worsen the functional problems. The clinical pattern is of particular interest as it helps to identify the muscles affected by spasticity and thus to determine an appropriate treatment. Some physicians use diagnostic nerve blocks (local transient anesthesia of nerve(s)) to evaluate the involvement of muscles in a specific spastic pattern), or electromyography (EMG, evaluating activity of muscles while the patient performs a movement or a task via external electrodes).
What should I do if I think I am developing spasticity?
Post-stroke spasticity is usually diagnosed and treated at rehabilitation centers, where many experts, such as, rehabilitation specialists, occupational therapists, physical therapists, speech therapists, psychologists, social workers, nurses…, work together to provide patients with different treatment options.
What forms of spasticity are prevalent in stroke survivors?
Spasticity can occur in the upper and lower limbs. The body region and the extent to which it is affected depend on the area of the brain or spinal cord that has been damaged.
- In spastic hemiplegia, the muscles of one side of the body are affected. Generally, injury to the left side of the brain will cause symptoms in the right side of the body, and vice versa. Hemiparesis is weakness on one side of the body. It is less severe than hemiplegia. Thus, the patient can move the impaired side of their body, but with reduced muscular strength.
- In patients with spastic diplegia, most often the lower limbs are affected, called then paraplegia. In that case, it is mainly related to a lesion of the spinal cord. Rarely diplegia concerns the 2 upper limbs.
- All four limbs are affected in patients with spastic quadriplegia. These patients are the least likely to be able to walk. This is mainly related to lesion of the spinal cord.
After my stroke two of my fingers are stiff, how do I know if this is spasticity?
Diagnosis of spasticity is mainly based on clinical evaluation that should include:
- Clinical history
- Physical examination
- evaluation of stretch reflexes (e.g., deep tendon reflexes, involuntary muscle contractions provoked by stretching the muscle with a tap on the tendon that connects the muscle to a bone)
- passive and active motion
- Function, e.g., toileting, eating, sleeping, dressing, sitting, standing, and walking
A proper assessment of the individual’s clinical and neurological status is critical in developing an effective treatment plan with achievable goals.
Spasticity is diagnosed if the patient shows an increased resistance to passive movements that increases with speed and typical positioning of the limbs, due to increased muscle tone. The diagnosis is not complicated for rehabilitation specialists but unfortunately a lot of other specialists/HCP are not trained and thus don’t recognized the symptoms or when they do so, don’t see the potential benefit of an adapted treatment.
The features of spasticity should be assessed individually for each patient, with the focus on three main areas: The clinical pattern of motor function, the patient’s ability to control his or her muscles, and how muscle stiffness and any contractures worsen the functional problems. The clinical pattern is of particular interest as it helps to identify the muscles affected by spasticity and thus to determine an appropriate treatment. Some physicians use diagnostic nerve blocks (local transient anesthesia of nerve(s)) to evaluate the involvement of muscles in a specific spastic pattern), or electromyography (EMG, evaluating activity of muscles while the patient performs a movement or a task via external electrodes).
What happens if I stop treating spasticity? Will my condition worsen quickly?
As a rule, spasticity will worsen when you stop treatment. Muscles and tendons shorten, the joints become stiffer and incorrect posture persists permanently without therapeutic intervention. This leads to an ever-increasing restriction of movement. The declining mobility makes coping with everyday life more difficult, reduces quality of life in general and will increase pain. . According to the International Classification of Function, Disability and Health (ICF) of the World Health Organisation (WHO), most people with spasticity are likely to experience a relevant reduction in their participation in social and professional life if spasticity is not treated. 6
6 CF is the WHO framework for measuring health and disability at both individual and population levels. ICF was officially endorsed by all 191 WHO Member States in the Fifty-fourth World Health Assembly on 22 May 2001(resolution WHA 54.21) as the international standard to describe and measure health and disability.
I’ve been clenching my hand for years. Is there hope for recovery?
It depends. Therapeutic methods such as physiotherapeutic mobilisation, hand orthoses or injections with botulinum toxin and ultimately surgery can be options to reduce spasticity. However, this requires a careful anamnesis and detailed examination. Talk to a physician about treatment options to decide on the right therapy concept for you.
Will spasticity keep me from walking?
Depending on brain and spinal cord damage, spasticity can cause limited mobility of the lower extremities and difficulties in walking. Since each individual is unique, this can only be answered by a doctor on the base of symptoms and findings.
Are alternative treatments such as yoga and thai chi effective to treat spasticity?
This depends on many factors, such as the cause and the extent of the injury to the brain and spinal cord. Through medical and physiotherapeutic treatments the spastic cramps in the muscles (at least in parts) can be solved. This leads to new mobility, which in many cases is accompanied by a high improvement in the quality of life.
What is the future for post stroke spasticity management?
Botulinum toxin injection is one of the most important treatment options in the future to reduce spastic muscle tone. The physiotherapeutic treatment and the drug therapy will continue to be the two main pillars in spastic therapy.
Alternative researchers are attempting to find ways to eliminate spasticity through neurosurgical procedures or other anti-spastic drugs.
Which type of toxins would suit better for post stroke spasticity?
There are 8 different sub-types (A, B, C1/C2, D, E, F, G and H) of the botulinum toxin which have been isolated, two of them (A and B) have been used therapeutically. Botulinum toxin type A injection represents the gold standard treatment for focal spasticity with efficacy, reversibility, and low prevalence of complications.
What are the health implications of using botulinum toxin frequently?
Botulinum toxin has been used for almost 30 years to treat spasticity. Out of these experiences it shows that botulinum does not cause long-term side effects. Microscopic examinations showed that no permanent changes have occurred in the nerves or muscles after absorbing Botulinum. After the effect ends, neither the active substance nor its effects on the nerves can be detected. As a calm muscle is usually weaker (think of a leg in a cast), with time a smaller dose of Botulinum toxin is going to be needed, to get the same muscle relaxing effect than before.
How long can I be treated with botulinum toxin?
The treatment with Botulinum toxin can be repeated for an indefinite period of time, if the active substance is well tolerated. Due to the degradation of Botulinum toxin after each injection, the paralysing effect is always reversible.
What can I do if my spasticity is not being treated?
Arrange an appointment with your general practitioner or family doctor and explain your symptoms. He or she can refer you to a specialist (usually this is a neurologist), who initiates further therapy and coordination.
Who do I see about getting a splint?
Orthoses / splints are usually recommended by the treating neurologist, rehabilitation specialist or physiotherapist in case of very strong or very low muscle tone. There are many different models with different functions.
What are the side effects of taking medication such as baclofen?
Unwanted side-effects of Baclofen are resulting from the central relaxing effect. These includes particular, drowsiness, sedation, exhaustion, restricted attention, memory deficit, nausea, confusion and muscle weakness, as well as hypotension, ataxia and paraesthesia. Please consult your doctor and / or the package leaflet for more detailed information.
Are there any risks with these medications?
All medications carry risks. Please consult an experienced health professional to assess the risk-benefit ratio of any medication.
When is it advantageous to use physiotherapy to treat spasticity?
Physiotherapy is the base of the treatment of spasticity. It keeps the affected muscles and joints mobile and flexible. Which of the physiotherapeutic exercises are suitable for each patient depends on the respective disease pattern.
Are treatments with baclofen tablets effective in all cases? If not, in which cases are they ineffective?
Sometimes, in case of chronic, very strong and extremely painful spasms, an oral dose of Baclofen is not sufficient. As an alternative, these patients have been given the intrathecal application of Baclofen through an implanted pump. This is a continuous therapy; however, in case of acute pains, a single injection of the active ingredient, into the spinal cord, is also possible.
What makes me eligible for treatment for spasticity?
If you have had spasticity after a stroke or an accident or due to a hereditary reason, than you are eligible to get treatment. Please consult an experienced health professional to assess which spasticity treatment is the most suitable for you.
Will my spasticity return once it has been treated?
This depends on many factors, such as the cause and the extent of the injury to the brain and spinal cord. Spasticity requires regular treatment until it reaches a point where further treatment is no longer required.
Which treatment option for spasticity is more effective?
A team of specialists will decide on the best treatment for you and this will vary from person to person. Treatment options can include physiotherapy, medication and botulinum toxin injections. Please consult an experienced health professional to assess which spasticity treatment is the most suitable for you.
I still experience spasticity after physiotherapy. Why didn’t this treatment work?
Spasticity usually responds well to multiple methods of treatment rather than just one. Physiotherapy usually works better in association with other treatments such as medications or botulinum toxin injections. Physiotherapy alone may reduce spasticity, but this is not the case for all stroke survivors.
Is amputating a limb ever an option to treat spasticity?
This is very unlikely and is only used when no other surgical option is available.
When spasticity is more prevalent in the feet, is it advisable to get surgery?
If spasticity affects only one or two specific parts of your body, you may be given botulinum toxin as an injection. The benefit of botulinum toxin has been established for various muscles affected by spasticity. The effects of botulinum toxin usually last for about three months. Botulinum toxin treatment should be given with further rehabilitation such as physiotherapy, or other treatments like splinting or casting. You should also have an assessment three to four months after the treatment.
source: Stroke Association (2012) Pain after stroke
Are treatments with botulinum toxin injections effective in all cases? If not in what cases are they ineffective?
If spasticity affects only one or two specific parts of your body, you may be given botulinum toxin as an injection. The benefit of botulinum toxin has been established for various muscles affected by spasticity. The effects of botulinum toxin usually last for about three months. Botulinum toxin treatment should be given with further rehabilitation such as physiotherapy, or other treatments like splinting or casting. You should also have an assessment three to four months after the treatment.
source: Stroke Association (2012) Pain after stroke
What is the best treatment for stroke survivors with spasticity?
When does the spasticity appear during a stroke?
38% of stroke survivors experience post-stroke spasticity within one year after a first stroke.
How is spasticity treated?
Is there any medication that will ease my spasticity?
How can you stop ongoing spasms?
The treatment of adult with spasticity should be provided by a multidisciplinary team employing a shared-care approach. A variety of treatment options is available and clinical experience has shown that a multi-modal approach has many benefits. In most cases, a combination of various types of treatment is required to achieve the specific goals of treatment for a particular patient.
A rehabilitation plan must be tailored to individual patient needs, and is likely to involve medical intervention (e.g., botulinum toxin, pain medication), as well as multiple additional therapies – for example physical, occupational and psychological approaches. Together, these therapies enable optimal management of functional problems such as impaired mobility, strength, balance, and endurance, amongst other spasticity-related issues.
The primary aim of treatment is to facilitate life for people with spasticity and for their caregivers, thus improving their quality of life. Therefore, improvement in function is a key long-term factor in spasticity management. Consequently, the development of realistic and clinically relevant goals for each individual patient is the key for a successful treatment. These goals should be defined and followed up in collaboration with other members of the spasticity management team that may include a specialist for physical medicine and rehabilitation, a neurologist, a physiatrist, a physiotherapist, an occupational therapist, a neurosurgeon, and an orthotist (specialist concerned with the design, manufacture and application of orthoses).
The importance of adapting the treatment to patients’ symptoms and especially to patients’ needs throughout the course of treatment is crucial, with expectations revisited and redefined if necessary at regular intervals.
What is the likelihood of developing post-stroke spasticity if I’ve had a stroke?
38% of stroke survivors experience post-stroke spasticity within one year after a first stroke, while the overall prevalence of post-stroke spasticity is approximately 0.2% (taken from the WHO MONICA project)
What medications can help?
When is it advantageous to use botulinum toxin to treat spasticity?
Botulinum toxin type A (BoNT/A) is recommended as a first-line therapy in national and international guidelines as part of an integrated treatment approach for post-stroke spasticity.
Botulinum toxin creates a ‘window of opportunity’ for improving motor and activity performance3 and should always be followed by physical therapy.
Which are the advantages of using physiotherapy to treat spasticity?
Physical therapy is the mainstay of treatment for spasticity, and is designed to reduce muscle tone, maintain or improve range of motion and mobility, increase strength and coordination, and improve care and comfort.
What are the advantages and the disadvantages of having surgery to treat spasticity ?
When not controllable by physical therapy, oral or intrathecal medications and/or botulinum toxin injections, spasticity symptoms can be treated with selective ablative procedures. In most cases, complementary neurosurgical and functional orthopedic approaches are used.
With surgical interventions, muscles can be denervated or tendons and muscles can be released, lengthened, or transferred to relieve the symptoms of spasticity. In practice, only 5% of spasticity patients undergo a surgical intervention.
By orthopedic surgery, muscles can be denervated, and tendons and muscles can be released, lengthened, or transferred. In order to release contractures, the contracted tendon is partially or completely split surgically and then the joint is repositioned at a more normal angle. A cast stabilizes the joint over a period of several weeks while the tendon regrows. After removing the cast, physical therapy is necessary to strengthen the muscles and improve the patient’s range of motion.
Surgical intervention that is used for the treatment of spasticity is called functional or selective dorsal rhizotomy (SDR). In this procedure, the neurosurgeon cuts nerve roots (rhizotomy) – the nerve fibers lying just outside the back bone (spinal column) that send sensory messages from the muscles to the spinal cord. ‘Selective’ indicates that only certain nerve roots are cut, and ‘dorsal’ refers to the target nerves that are located at the back of the spinal cord (the upper surface when a person is lying on his or her stomach).
Is the spasticity infectious in any way?
No, spasticity isn’t contagious. It cannot be transmitted by direct or indirect contact.
Can spasticity heal by itself?
Spasticity cannot heal by itself or disappear without treatment. The symptoms and complications are likely to worsen without therapeutic intervention.
Do all stroke survivors develop spasticity?
38% of stroke survivors experience spasticity within one year after a first stroke¹. The percentage frequency is distributed as follows:
- 27 percent after one month
- 28 percent after three months
- 23–43 percent after six months
- 34 percent after 18 months after the stroke²
1 Watkins CL, Leathley MJ, Gregson JM, Moore AP, Smith TL, Sharma AK. Prevalence of spasticity post stroke. Clin Rehabil. 2002;16(5):515-22.
2 Kuo Ch. et al. Post-stroke Spasticity: A Review of Epidemiology, Pathophysiology, and Treatments. International Journal of Gerontology 2018; Volume 12, Issue 4, Pages 280-284. Review Article 2018/06/19.
Why does a considerable proportion of stroke patients develop spasticity yet others do not?
Approximately 38% of stroke survivors experience post-stroke spasticity within one year after a first stroke, while the overall prevalence of post-stroke spasticity is approximately 0.2% (taken from the WHO MONICA project). If a spasticity will be developed or not, depends on the type, the localization and the extent of the brain damage, and which areas of the brain are affected.
Physiotherapy, which has been started with at an early stage, can counteract a spasticity and delay its occurrence. Spasticity also occurs when an impatient patient starts an ambitious rehab training after the stroke. Besides the movement for the rehabilitation, it is also important to rest to recover. Therefore an individual, personal training program, tailored to the patient, is very important. Careful consultation with a physician is essential in order to ensure proper planning during a recovery phase.
What causes spasticity?
Spasticity is one of several clinical features/motor behaviors that may result following damage to the part of the brain or spinal cord involved in controlling voluntary movement. Collectively, these features are known as the upper motor neuron (UMN) syndrome. Spasticity is associated with a pathologically increased muscle tone. This creates stiffness and resistance to passive movement (the word ‘spasm’ originates from the Greek word, ‘spasmos’, which means to drag or pull). This change in muscle tone may increase the disability related to the disease at the origin of spasticity.
What causes the muscles to contract?
Spasticity is one of the features of upper motor neuron (UMN) syndrome. UMN syndrome is caused by damage to one (or more) areas of the central nervous system (CNS) involved in controlling voluntary movement. UMN syndrome can be divided into two broad groups – negative phenomena and positive phenomena.
Negative phenomena refer to what is lost, such as fine motor skills, strength, and motor control.
Positive phenomena are characterized by an abundance of muscle hyperactivity, such as spasticity, hypereflexia (increased stretch reflexes), clonus (uncontrollable movement of a body limb, especially the ankle), co-contractions (involuntary contractions of a limb or a part of the limb while the patient is actively moving another part (e.g., lower limb) (e.g., adduction of the shoulder while walking), or muscles spasms.
How soon after a stroke does spasticity develop?
38% of stroke survivors experience post-stroke spasticity within one year after a first stroke.
Why & how does spasticity develop?
Spasticity is one of several clinical features/motor behaviors that may result following damage to the part of the brain or spinal cord involved in controlling voluntary movement. Collectively, these features are known as the upper motor neuron (UMN) syndrome. Spasticity is associated with a pathologically increased muscle tone. This creates stiffness and resistance to passive movement (the word ‘spasm’ originates from the Greek word, ‘spasmos’, which means to drag or pull). This change in muscle tone may increase the disability related to the disease at the origin of spasticity.
