Spasticity Management Flashcards

1
Q

What is spasticity?

A

velocity dependent increase in muscle tone

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2
Q

what do mild cases of spasticity look like?

A

exhibit hyperreflexia
not spontaneously active

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3
Q

what do severe cases of spasticity look like?

A

loss of function
sleep disturbance
pain
poor quality of life
permanent contractures
postural abnormalities

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4
Q

can electrotherapy help manage spasticity? If so, how?

A

yes, if you intervene early before long term contractures occur.

produce muscle contractions to re-educate pathways and increase strength

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5
Q

shape of contraction is determined by?

A

frequency
amplitude
pulse duration
ramp time

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6
Q

why are we concerned with ramp time?

A

because spasticity is velocity dependent. duh. you want a slow/gradual ramp time

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7
Q

T or F? there is a set optimal parameter to use NMES to treat spasticy

A

lol false. parameters difficult to define because it depends on the patient

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8
Q

does the literature support NMES for spasticity reduction?

A

yes, but they use different outcome measures and some look at short or long term effects

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9
Q

what frequency range do we want?

A

30-50 but up to 100 might be feasible*

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10
Q

greater frequency = greater

A

fatigue (muscle damage)

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11
Q

why would greater fatigue be a good thing?

A

want to fatigue so antagonistic muscle can move

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12
Q

what pulse duration

A

300-500 us

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13
Q

what amplitude

A

greater than 100mA

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14
Q

what are some ways to use NMES?*

A
  • antagonistic muscle stimulation
  • spastic muscle stimulation
  • combined agonist and antagonist
  • long-term NMES in SCI patients
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15
Q

antagonistic muscle stimulation*

A

if elbow flexor spasticity, apply NMES to triceps

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16
Q

spastic muscle stimulation*

A

if elbow flexor spasticity, applied to elbow flexors

goal may be to fatigue, think about increased Hz

17
Q

will NMES help all spasticity cases?

A

nope

18
Q

what are some issues with current lit on NMES and spasticity

A
  • varying outcome measures
  • reliability/validity of outcome measures
  • heterogeneity of subject pop
  • lack of control groups
  • variation of stimulation parameters
  • patient input required for any treatment