
Spasticity is a common post-stroke condition, affecting 25% to 43% of survivors in the first year after their stroke. It causes stiff or rigid muscles, making it difficult to move and stretch, and can lead to permanent muscle shortening if left untreated. Spasticity occurs when the brain's signalling to the muscles is damaged, resulting in involuntary muscle contractions. This can cause pain and affect mobility, with arms and hands becoming difficult to move and leg muscles impacting walking. Treatments include physical therapy, medication, injections of botulinum toxin, and surgery.
Characteristics | Values |
---|---|
Prevalence | 25% to 43% of stroke survivors experience spasticity in the first year after their stroke |
Age | More common in younger stroke survivors |
Stroke type | More common in strokes caused by a bleed |
Symptoms | Stiff or rigid muscles, painful muscle spasms, decreased function, difficult stretching, stiffness in the arm, hand, leg and ankle, bent elbow, clenched fist, foot pointed down, arm folded against the chest |
Treatment | Physical exercise and stretching, injections of botulinum toxin, oral medications, functional electrical stimulation, intrathecal baclofen therapy, braces, serial casting and splinting, surgical procedures |
What You'll Learn
Spasticity is a common post-stroke condition
Spasticity can develop within a week of a stroke or some time later, and it typically occurs between 3 and 6 weeks after the stroke. It is more common in younger stroke survivors and those who have experienced a bleed in the brain. The condition can cause a range of physical symptoms, including tension in the fingers, a bent wrist, a clenched fist, a bent arm held against the chest, and a bent or pointed foot.
If left untreated, spasticity can lead to permanent muscle contractures, where the muscles become shortened and joints become locked in abnormal and painful positions. This can further reduce the range of motion and increase the burden on caregivers. Therefore, early treatment is crucial to managing spasticity and improving quality of life.
Treatment options for spasticity include physical therapy, exercises, injections of botulinum toxin, oral medications, and surgical procedures. Physiotherapists and occupational therapists play a vital role in spasticity management, recommending exercises to improve movement and control and prevent pain. They may also suggest casting, taping, and electrical stimulation techniques to stretch and lengthen tight muscles.
In addition to medical treatments, lifestyle adjustments can help reduce the symptoms of spasticity. This includes modifying your home environment, such as installing ramps and grab bars, using mobility aids, and regularly changing positions to prevent muscles and joints from becoming stiff.
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It causes stiff or rigid muscles
Spasticity is a common post-stroke condition that causes stiff or rigid muscles. It occurs when a muscle involuntarily contracts when you move and commonly affects the elbow, wrist, and ankle. This involuntary contraction can make it difficult for a person to move their arm or leg as they would like. For example, they may try to move their arm, but it doesn't move easily or as much as expected.
The stiffness and tightness in the muscles can lead to a reduced range of motion, making simple tasks more challenging and causing significant difficulty with daily living activities such as bathing, eating, and dressing. If left untreated, spasticity can also result in a condition called contracture, where the joints in the arm and leg become stuck or frozen in an abnormal and possibly painful position.
The underlying cause of spasticity is related to interruptions in the nervous system signals that control muscle movement and stretching. Specifically, it is associated with injuries to the parts of the brain that send and receive messages to the muscles. This results in hyperexcitability of the stretch reflex, leading to increased resistance during passive stretch.
Managing spasticity typically involves a combination of treatments, including physical exercise, stretching, oral medications, and injections. It is important for individuals experiencing spasticity to stay as active as possible and continue with their prescribed exercises, as reduced movement can worsen the condition.
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It can lead to permanent shortening of the muscles
Spasticity is a common post-stroke condition that causes stiff or rigid muscles. It occurs when a muscle involuntarily contracts when you move and commonly affects the elbow, wrist, and ankle. Spasticity can lead to permanent shortening of the muscles, known as a contracture. This happens when the muscle cannot complete its full range of motion, causing the surrounding tendons and soft tissue to tighten. This makes stretching the muscle much more difficult and, if left untreated, can result in joints becoming stuck or frozen in an abnormal and painful position.
Contractures can affect the arms, hands, and legs in various ways. For example, an arm may remain in a bent position, making it difficult to get dressed, or a leg may become difficult to walk with. The effects of a contracture will depend on the joint affected and the severity of the condition.
To prevent and treat spasticity and contractures, it is important to stay active and do exercises that help to stretch and lengthen the muscles. Physiotherapy and occupational therapy can provide valuable assistance in this regard. In more severe cases, doctors may prescribe botulinum toxin injections or muscle relaxant medication to help relieve spasticity.
The risk of developing contractures increases if spasticity is not treated. Therefore, it is crucial to seek medical advice and develop a treatment plan that suits your specific needs and goals.
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Treatments include physical therapy, medication and surgery
Spasticity is a common post-stroke condition, affecting 25-43% of survivors in the first year. It causes stiff or rigid muscles, which can make everyday tasks difficult. Treatments include physical therapy, medication, and surgery.
Physical Therapy
Physical therapy and exercise are important for managing spasticity. Physiotherapists and occupational therapists can recommend exercises to lengthen and strengthen muscles, and teach new ways of performing everyday tasks. It is important to stay active and keep doing exercises, as inactivity can worsen spasticity.
Medication
Medications can be used to block nerves and relax muscles. Injections of botulinum toxin can be used to weaken or paralyse overactive muscles. Oral medications can also help relax nerves, but may have side effects such as weakness, drowsiness, or nausea. Intrathecal baclofen therapy (ITB) is another option, where a small pump is surgically implanted to deliver medication directly to the spinal cord.
Surgery
Surgery may be considered for severe cases of spasticity that do not respond to other treatments. Surgical procedures can include interventions in the posterior root entry zone or dorsal rhizotomy, partial neurotomy of the motor branches of the tibial nerve, or orthopedic surgery such as tendon transfer or muscle lengthening.
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Lifestyle changes can help reduce symptoms
Spasticity is a common post-stroke condition that causes stiff or rigid muscles. It occurs when a muscle involuntarily contracts when you move and commonly affects the elbow, wrist and ankle. About 25% to 43% of survivors will have spasticity in the first year after their stroke. It is more common in younger stroke survivors.
Lifestyle changes can help reduce the symptoms of spasticity:
Exercise and stretch
Regular exercise and stretching can help maintain full range of motion and prevent permanent muscle shortening. Physiotherapists and occupational therapists can recommend exercises to lengthen and strengthen your muscles. The less you move, the worse muscle spasticity may get.
Adjust your posture
Try to avoid staying in one position for too long. This can cause muscles and joints to get stiff and sore. Switch positions every 1–2 hours to help keep the body limber.
Support affected limbs
Providing extra support for affected limbs can also keep you more comfortable and reduce the effects of spasticity. For example, try not to let your arm or leg fall off the side of the bed or wheelchair. Be mindful when lying down. Placing your affected arm or leg under your body when resting can worsen spasticity. Lying on your back can help keep your limbs in a more comfortable position.
Work with an occupational therapist
Occupational therapists can help stroke survivors learn new ways of performing everyday tasks more easily. This may mean learning to get dressed with the opposite hand, or modifying eating habits.
Use mobility aids
If spasticity has made it difficult to get around after a stroke, using mobility aids can help you move more easily. Common mobility aids include braces, canes, walkers and wheelchairs.
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