Spasticity is a common side-effect of stroke

Posted: Published on September 21st, 2012

This post was added by Dr Simmons

Q: My husband is recovering from a stroke, which he experienced six months ago. His entire right arm is stiff, and his hand is held in a clenched fist. This makes it hard for him to do daily tasks, such as putting on a shirt. Is this common?

A: Stroke, spinal cord injury, and acquired brain injury can be devastating illnesses. These diseases affect the central nervous system, which consists of the brain and the spinal cord. When first diagnosed with a potentially devastating nervous system disease, the first thing a person thinks about is survival. Secondly, they may become focused on the deficits parts of the body that just arent working right. For example, after a stroke, some patients experience problems speaking and understanding. Others have difficulty walking or using their hands. With rehabilitation treatment, some deficits may improve significantly in short order, while others may take more time. Sometimes, there will be some residual deficits.

Spasticity is one of those challenging deficits. Its a condition where there is altered muscle function. In the simplest terms, the muscle is simply overactive working without full control of the brain and spinal cord. The result is muscle tightness, stiffness and, sometimes, involuntary movement. The severity of spasticity varies from person to person. For example, the arm and hand may appear to be held in an uncomfortable position, with the fingers in a clenched fist. This can make some tasks, such as getting dressed or bathing, difficult for patients and caregivers. In the legs, spasticity can make it difficult to walk or to use the toilet. Spasticity can be painful and, in some cases, can contribute to the formation of skin ulcers. For those affected, spasticity can profoundly diminish quality of life.

Although spasticity cant be cured, there are a number of treatments available that can help. These include physiotherapy, braces, prescription medications as well as the injection of medications. The optimal treatment strategy is different for each patient.

Toward this goal of meeting the varied needs of people with spasticity, Hamilton Health Sciences, in partnership with McMaster University, has launched the adult Comprehensive Spasticity Management Program. The foundation of effective spasticity management is expert clinical assessment. This unique program is comprised of a multidisciplinary team of specially trained care providers, each contributing to the development of the patients treatment plan. This includes physicians who are specialists in physical medicine and rehabilitation, as well as seasoned physical therapists, occupational therapists, nurses, and specialists who can make and fit braces. The treatment team also includes medical doctors who are pursing residency training to become the next generation of specialists.

The Comprehensive Spasticity Management program is located at Hamilton Health Sciences Regional Rehabilitation Centre, 300 Wellington St. N. For more information, please visit: http://www.hamiltonhealthsciences.ca/spasticity.

House Calls is written weekly by experts at Hamilton Health Sciences. Dr. Shanker Nesathurai is chief of physical medicine and rehabilitation at Hamilton Health Sciences and St. Josephs Healthcare Hamilton, and serves as division director with McMaster University.

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Spasticity is a common side-effect of stroke

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