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- Spasticity is a poorly understood
post stroke condition which causes stiff
or rigid muscles.
It most commonly effects movement
of the elbow, wrist, and ankle.
In this video we'll talk about
the effects of spasticity on daily life.
We'll also identify treatments
and ideas for managing spasticity after a stroke.
Stroke survivors have identified
spasticity as one of the top three
most bothersome post stroke conditions.
A recent survey shows as many as
two out of every three stroke survivors
report some spasticity.
Of those nearly a fourth report
that spasticity interferes with their daily life.
However only about half of all sufferers
report receiving treatment for their spasticity.
Untreated spasticity increases healthcare costs
by as much as 400%.
Severe spasticity also increases
the likelihood of living in an institution
because of the difficulty of attending
to the activities of daily living.
Spasticity can appear in the first few days
after a stroke
or show up weeks, months, or even years later.
Every situation is different.
So what causes spasticity?
Follow a stroke, interruptions in the signals
between your brain and your muscles
can keep your muscles from relaxing
the way they should.
Instead they spasm uncontrollably,
much like having a charlie horse.
Because the muscle isn't properly stretching,
it can become stiff.
That stiffness can eventually lead
to muscle shortening
and can produce a tight fist, bent elbow,
stiff knee, pointed foot,
or other stiffness in your arms, fingers, and legs.
Left untreated it can lead to bone
and joint deformities.
When spasticity limits activity,
it often can cause other problems.
Having stiff, tight joints can seriously
impact daily living.
It can make it difficult to stay clean,
dress, move around easily,
and frequently causes pain
which can interfere with sleep.
The inability to move easily can
lead to medical problems like pressure or bed sores
and even pneumonia.
Additionally spasticity can negatively impact
your ability to socialize and enjoy hobbies.
This often leads to social isolation and depression.
Because spasticity effects everyone differently,
successful treatment requires a team effort.
This includes the survivor, family and caregivers,
and healthcare professionals.
The first step is talking to your
healthcare professional to develop
a treatment plan specific to your needs.
There are a number of treatment options available
that can be used alone
or in combination with each other.
Remember, not all treatments are appropriate
for every person.
Physical and occupational therapies
are the first action taken to treat spasticity.
Stretching and range of motion activities
help to keep the joints mobile
and prevent muscles from shortening.
The use of orthotics or splints and casts
can help keep the muscles in a stretched position.
This improves range of motion.
Orthotic devices can also help provide joint stability,
allowing for safer movement and better mobility.
Oral medications or pills can improve
spasticity in people with moderate symptoms.
One drawback is because they circulate
throughout the blood stream,
pills effect nearly all the muscles in the body,
not just those with spasticity.
Another treatment is injections into
only the effected muscles.
These injections take a couple
of weeks to take effect
and work best if used together
with physical therapies.
They work by blocking the chemical signals
that tell the muscle to contract.
A treatment option for severe spasticity
is intrathecal baclofen, or ITB therapy.
This involves the delivery of the drug,
baclofen, directly into the spinal fluid.
The delivery system keeps the drug
from going through your entire
blood stream like a pill would.
A pump is surgically placed under the skin
near the abdomen.
The pump delivers constant doses of the drug
that can be adjusted to fit your particular needs.
The final treatments for spasticity,
used only when other treatments haven't worked,
are surgical.
There are two types that are commonly used.
Orthopedic surgery and neurosurgery.
Managing spasticity at home is a team effort.
Physical and occupational therapists
will make recommendations that can help.
These may include using the appropriate assistive devices,
aids, and home adaptations.
The goal is to help ensure your safety
and reduce the risk of spasticity related falls.
Some modifications in your home
might include grab bars, raised toilet seats,
shower or tub bench, braces, canes,
or a walker to help you move about freely
as you gain strength and balance.
Your healthcare team may recommend
a variety of treatments for your spasticity,
but the first step is talking to your
healthcare professional about your situation.
Visit www.stroke.org for more information
about treating and managing spasticity after a stroke.
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