Management of Spasticity Revisited

Laura A. Graham


Age Ageing. 2013;42(4):435-441. 

In This Article

Clinical Presentations

There are no large studies of the natural history of spasticity and contracture development, but permanent loss of joint range has been known to occur within 3–6 weeks after stroke[7] and acute brain injury.[8] It is therefore important to identify and treat spasticity early and some small studies have shown a benefit in a proactive approach using injections of botulinum toxin[9]

In hemiplegia, the lower limb pattern is plantar flexion and inversion at the ankle with hamstring tightness limiting range of movement at the knee adductor spasticity, causing the knees to be pulled together, has implications for personal hygiene, sexual function and seating. Spasticity can cause painful spasms, and the nature and pattern of these movements needs to be fully explored to establish positional trigger points which may be potential targets for physical therapy interventions or intramuscular botulinum toxin injection.