This chapter presents the technology of spasticity treatment-from diagnosis and treatment to quality control of treatment and rehabilitation. The diagnosis is based on methods of manual testing and differential diagnosis of spastic muscles, methods of quantitative assessment of spasticity on the basis of the Tardieu scale. The methodical development of the Tardieu scale with variants of its full and reduced use is presented. The basic patterns of spasticity of the upper and lower limbs are given. Schemes of management of patients with spasticity with indication of control points for application of methods of an assessment that shows efficiency of treatment and rehabilitation are presented. The methodology of spasticity treatment using botulinum neurotoxin (BoNT), including ultrasonic navigation, orientation of intramuscular motor endpoint of muscles (IME), is described. IME location diagrams and ultrasound picture of muscles are presented. Scales are proposed to assess the effect of spasticity on the functions of the upper and lower limbs. In conclusion, a variant of complex treatment of spasticity and original patient models are proposed, the use of which makes it possible to calculate the cost of BoNT.
Spasticity treatment remains an urgent problem of modern neurorehabilitation. The targeted injection of botulinum neurotoxin (BoNT) into the muscle motor points (MPs) is gaining more and more popularity. But there are insufficient data on the position of MPs, while a MP search methodology has not been worked out yet. Most information about MPs has been obtained on cadaveric material using anatomical dissection or Sihler’s staining technique. Clinical data on the targeted injection of BoNT into the MPs are contradictory, which may be due to the inaccurate determination of their position.Objective: to verify upper and lower limb muscle MPs through electromyography (EMG).Patients and methods. Forty healthy volunteers were examined and underwent anthropometric assessment. Upper and lower limb muscle projections were completely scanned using EMG and ultrasound.Results and discussion. The anatomical localization of MPs in the upper and lower limb muscles involved in spasticity patterns was determined. The position of MPs was found to populationally identical, to have a slight deviation associated with the limb length, and to be unrelated to gender, age, and limb dominance. Original tables and maps for limb MP localization were created.Conclusion. The findings can enhance the efficiency of BoNT administration and improve the quality of rehabilitation measures, since the use of reliable information on the position of MPs will allow targeted BoNT injection in the immediate vicinity of the site of biological action. In clinical practice, this opens a window of opportunity for the early initiation of rehabilitation measures aimed at restoring movement.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.