Spasticity is a poorly understood post-stroke condition which
causes stiff or rigid muscles.
It most commonly affects 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.
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?
Following 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 affects 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.
Oral medications or pills can improve spasticity in
people with moderate symptoms.
One drawback is that because they circulate throughout the
bloodstream, pills affect nearly all the muscles in the body.
Not just those with spasticity.
Another treatment is injections into only the affected 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 muscles 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
bloodstream, 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, cane 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.