STROKE-MOBILITY INTERVENTIONS, SPASTICITY

SUMMARY

1. Spasticity management: Botulinum Toxin A injections used to treat focal spasticity has been shown to improve spasticity when compared to conventional care and may improve functional ambulation & gait.

2. It works best in combination with an ankle foot orthosis, but not with electrical stimulation, taping, or stretching.

3. Oral anti-spastic medications may improve ADLs, howevere side effects are important to consider.

4. TENS has been suggested to reduce muscle tonicity through an enhancement in presynaptic inhibition of the spastic plantarflexors, or a disinhibition of descending voluntary commands to the paretic dorsiflexors (Bakhtiary & Fatemy, 2008).

5. It is an effective intervention for reducing lower limb spasticity post stroke, while neuromuscular/functional electrical stimulation may not be effective.

Reference(s)

1. Bakhtiary, A. H., & Fatemy, E. (2008). Does electrical stimulation reduce spasticity after stroke? A randomized controlled study. Clinical Rehabilitation, 22(5), 418-425.
Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.