If you've experienced muscle weakness following a stroke, it's crucial to seek assessment for spasticity from a neuro specialist.
Addressing spasticity through appropriate therapy is vital to reduce the risk of contractures in your joints and muscles. In recent years, significant advancements have been made in spasticity management programs, offering a range of treatments such as physiotherapy, botulinum toxin injections, and medications like baclofen. Let's delve into these treatment options and their potential benefits in improving your mobility and overall function.
The Power of Physiotherapy:
Physiotherapy plays a pivotal role in managing spasticity. Daily sessions are recommended to actively move your muscles and joints, preserving muscle condition, promoting flexibility, and minimizing the likelihood of contractures. Your skilled physiotherapist will utilize techniques such as positioning, passive/supported movement, and active movement to gently guide your affected limb into various positions. By normalizing muscle tone and promoting function on both affected and unaffected sides, physiotherapy aims to optimize your overall mobility and quality of life.
Botulinum Toxin Type A: A Valuable Ally:
Supporting your rehabilitation journey, botulinum toxin type A can be injected directly into the affected muscle by a doctor or physiotherapist, often guided by ultrasound. Commonly known by brand names such as Botox, Dysport, and Xeomin, this treatment works by blocking nerve signals to the muscle, reducing its ability to contract excessively. As a result, muscle tone decreases, facilitating rehabilitation and making it easier for you to regain control and straighten your limbs.
Botulinum toxin type A injections are typically used for post-stroke spasticity in the hands, wrists, and ankles. The muscle-relaxing effects of the injection generally last for about three months, with some patients reporting benefits lasting up to six months. It's important to note that these injections do not impact muscle sensation. To ensure the preservation of any range of motion gained, post-injection treatment should include physiotherapy or other measures such as splinting or casting. Regular reassessment after three to four months is crucial, and further injections may be recommended if positive changes are observed.
Medications for Spasticity Management:
In cases of generalized spasticity or when botulinum toxin A treatment doesn't yield the desired reduction in spasticity, medications can be a valuable adjunct to relax stiff muscles and alleviate related pain. There are various medications available, each with a slightly different effect on the nervous system but ultimately aiding muscle relaxation. By reducing muscle stiffness and spasms, these medications enable easier movement and increased range of motion.
Baclofen and Tizanidine are commonly prescribed as initial medications for spasticity management. However, if these prove ineffective, there are alternative drugs that may be considered. It's important to note that these medications should only be prescribed by specialists with expertise in spasticity management.
Remember
Managing spasticity after a stroke is essential for enhancing mobility and overall function. Through the combined efforts of physiotherapy, botulinum toxin injections, and medication, individuals with spasticity can experience improved muscle control, reduced stiffness, and a greater range of motion. Collaborating with a knowledgeable healthcare team and adhering to personalized treatment plans can pave the way for enhanced rehabilitation and a better quality of life.
References:
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Turner-Stokes L, Fheodoroff K, Jacinto J, Maisonobe P, Zakine B, European Society of Physical and Rehabilitation Medicine (ESPRM) and the European Union of Geriatric Medicine Society (EUGMS). Results from the Upper Limb International Spasticity Study-II (ULIS-II): a large, international, prospective cohort study investigating practice and goal attainment following treatment with botulinum toxin A in real-life clinical management. BMJ Open. 2013;3(9):e002771. doi: 10.1136/bmjopen-2013-002771. PMID: 24056419; PMCID: PMC3774415.
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Salbach NM, Veerbeek JM, van Langeveld SA, et al. Exercise training improves arm function in chronic stroke: a pilot study. J Neuroeng Rehabil. 2018;15(1):71. doi: 10.1186/s12984-018-0418-4. PMID: 30115071; PMCID: PMC6095853.
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