Cпастичность-важнейшая составляющая синдрома пор ажения верхнего двигательного нейрона, которая выявляется более чем у 12 млн больных в мире и по разным данным, является причиной инвалидизации 12-27% из них [1, 2]. Перечень нозологических форм, при которых в структуре синдрома поражения верхнего мотонейрона (ПВМ) наблюдается спастический гипертонус, значителен. Он определяется примерно у 20-40% выживших после инсульта, у 65-78% пациентов с поражениями спинного мозга и у 85% больных рассеянным склерозом [3-5]. Интерес к этиопатогенезу, клинике, диагностике и лечению спастичности проявлялся со времени формирования неврологии, но особенно интенсивно спастичность из
The problem-oriented approach in the rehabilitation of patients with spasticity requires careful assessment of the situation in the concept of The International Classification of Functioning, Disability and Health (ICF): impairment of the structure, functions and limitation of activity in specific environmental factors. Standardized tools in the assessment of muscle tone allow to get objective data about motor function. The use of the Modified Ashworth scale (MAS) and the Tardieu Scale are discussed. The standardized assessment of independent mobility is an important issue in outcome measuring. The ultimate goal of intervention, including the use of botulinum toxin therapy in the case of spasticity, is to support patient's daily activities. The article presents scales and tests for assessment of mobility: The Hauser Test, the Rivermead Mobility Index and functional assessment walking tests. The authors describe a clinical case of lower limb spasticity treatment with abobotulinumtoxin A and its assessment with these scales.
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