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Post-Stroke spasticity made simple
Among the many serious consequences of a stroke, one of the most physically debilitating is "spasticity," or uncontrolled muscle tightness often accompanied by pain and reduced function, such as difficulty walking and using hands. "Restricted movement can make day-to-day life a struggle," said Dr. Anne-Louise Lafontaine, a neurologist and director of the Movement Disorders Clinic of the McGill University Health Centre. The extent of spasticity varies
greatly between patients. Some patients have very subtle spasticity, such as
bent fingers or a specific uncontrolled movement when performing a particular
task. Other patients are have severe spasticity, not being able to dress
themselves or perform even the simplest activity of daily living.
Dr. Saty Sharma, physiatrist specializing in spasticity rehabilitation at Sunnybrook and Women's College Hospital in Toronto, Ontario [verify title] urges caregivers to be watchful for potential spasticity in a stroke patient. "Patients have a multitude of issues after stroke and may not be able to recognize the reasons for their pain or restricted function. In such case, a caregiver, a family member and a physiotherapist should alert the doctor to potential spasticity and ask for referral to a spasticity clinic," he said. It is important to make a distinction between focal and generalized spasticity. Focal spasticity affects a smaller part of the body, such as a hand or an extremity. Generalized spasticity affects greater areas of the body or the whole body. The approach to treatment will vary depending on whether you (or your loved one) suffer from focal or generalized spasticity. "The treatment usually involves a
combination of physiotherapy, occupational therapy and if need be, a medical
treatment," explained Dr. Lafontaine. "For focal spasticity, I use Botox as the
first line because it is simple, effective and has virtually no side effects.
It is injected at first every three months. In some patients, injections twice
a year can maintain the goals of therapy. The effect can be cumulative. So, it
might take two or three injections to see the full extent of improvement."
The extent to which spasticity can be
rehabilitated varies between patients. Some of the factors that may affect the
success are the patient's age, the extent of brain damage, the ability of the
brain to repair itself and the time after stroke. However, "it is very
difficult to predict the degree of success for a particular patient," said Dr.
Lafontaine. "Some patients achieve a reasonable success with treatment of
spasticity even years after the stroke while others see a lesser improvement or
not at all. The best is to start treatment as soon as possible." visit www.strokerecoverycanada.com or Call us at 1-888-540-6666 |
