Category: Miscellaneous

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.

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.