Spasticity Treatment Flashcards
What are the goals of physiotherapy treatment sessions for spasticity?
Improve function and work towards patient goals at activity and participation level. Maintain muscle length and joint mobility.
What is the role of Spasticity Clinics?
MDT review to provide holistic assessment and management. Focus on long-term management.
What types of medications are used for spasticity?
Systemic medications include baclofen (oral/pump), tizanidine, etc. Focal medications include Botulinum Toxin, Phenol, etc.
What are the benefits of FES/NMES in spasticity treatment?
Facilitates reciprocal inhibition and motor re-learning.
What are the purposes of splinting and casting in spasticity management?
Maintain muscle length and improve joint mobility through splinting and orthotics, as well as serial casting.
What surgical procedures are available for spasticity treatment?
Tendon lengthening or transfer and selective dorsal rhizotomy.
What are the treatment and management goals for spasticity?
Optimize function and prevent secondary complications. Utilize evidence-based and clinical reasoning for effective management.
How does activity impact spasticity?
Activities that inhibit spasticity can lead to useful neuroplastic changes, while those that reinforce spastic movement patterns can lead to maladaptive changes.
What is the action of spasticity medications?
Reduce muscle tone by acting on CNS or skeletal muscle, increasing inhibitory signals or decreasing excitation signals.
What is the mechanism of Baclofen?
Binds to GABA-B receptors to increase inhibitory effects of GABA, inhibiting spinal reflexes by reducing muscle spindle sensitivity.
What are the side effects of Baclofen?
Sedation, drowsiness, fatigue, reduced attention, lowering of seizure threshold, and cognitive function deterioration.
What is the mechanism of Tizanidine?
Impairs release of excitatory neurotransmitters and increases pre-synaptic inhibition of motor neurons.
What are the side effects of Tizanidine?
Drowsiness, bladder and bowel changes, cardiovascular changes, blurring of vision, dyskinesia, and cognitive/mental health deterioration.
What is the importance of functional task practice?
Intensity and repetitions are crucial for neuroplasticity. It aims to improve function and reduce secondary changes.
What are the positioning strategies for individuals with spasticity?
Use modified supine or side lying positions with supportive aids, maintain midline alignment in sitting, and facilitate weight bearing in standing.
What are the indications for splinting?
Clear goals, excessive hypertonia, reduced range of movement and function, and lack of compliance with stretching programs.
What are the precautions or contraindications for splinting?
Reduced skin health, impaired circulation, challenging behaviors, poor compliance, and impaired cognition or communication.
What should be measured following treatment?
Measurement should align with the ICF Problem List: Body Functions and Structures, Activities, and Participation.
What are some outcome measures for spasticity treatment?
Goal Attainment Scaling (GAS), Modified Ashworth Scale (MAS), Tardieu Scale, Focal Spasticity Index (FSI), and patient-reported experiences.
What are the key take-home messages regarding spasticity management?
Aim to optimize function and prevent complications, involve the whole MDT, and ensure effective communication and teamwork.
