Peripheral Mechanisms Contributing to Spasticity and Implications for Treatment

Stecco, Antonio; Stecco, Carla; Raghavan, Preeti

doi:10.1007/s40141-014-0052-3

Cited by 53 publications

(48 citation statements)

References 76 publications

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“…Immobility in turn can begin a vicious circle of problems including peripheral soft-tissue changes that reduce tissue compliance, potentiation of reflex mechanisms and spasticity, eventually leading to muscle fibrosis and contributing to abnormal limb posturing, pain and decreased function (Figure 2) (Stecco, Stecco et al 2014). Spasticity is now thought to arise as a consequence of contractures rather than being a cause of contractures (Ward 2012).…”

Section: Learned Nonusementioning

confidence: 99%

Upper Limb Motor Impairment After Stroke

Raghavan

2015

Physical Medicine and Rehabilitation Clinics of North America

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283

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Synopsis Understanding upper limb impairment after stroke is essential to planning therapeutic efforts to restore function. However determining which upper limb impairment to treat and how is complex for two reasons: 1) the impairments are not static, i.e. as motor recovery proceeds, the type and nature of the impairments may change; therefore the treatment needs to evolve to target the impairment contributing to dysfunction at a given point in time. 2) multiple impairments may be present simultaneously, i.e., a patient may present with weakness of the arm and hand immediately after a stroke, which may not have resolved when spasticity sets in a few weeks or months later; hence there may be a layering of impairments over time making it difficult to decide what to treat first. The most useful way to understand how impairments contribute to upper limb dysfunction may be to examine them from the perspective of their functional consequences. There are three main functional consequences of impairments on upper limb function are: (1) learned nonuse, (2) learned bad-use, and (3) forgetting as determined by behavioral analysis of tasks. The impairments that contribute to each of these functional limitations are described.

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Section: Learned Nonusementioning

confidence: 99%

Upper Limb Motor Impairment After Stroke

Raghavan

2015

Physical Medicine and Rehabilitation Clinics of North America

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283

198

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“…Over time, there are also changes in the arrangement of collagen fibrils in the endomysium. Changes in the turnover of HA and in the properties of extracellular matrix may lead to structural and functional changes in the muscles, which has a significant impact on the movement [17,19]. Alteration of HA could also modify the activation of the receptors, producing nonspecific musculoskeletal pain [11,17,20].…”

Section: Discussionmentioning

confidence: 99%

Observation using thermography of post-operative reaction after fascial manipulation®

Fidut-Wrońska

Chołuj

Chmiel³

et al. 2019

Ann Agric Environ Med.

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Introduction and objective.Fascia Manipulation® is one of the methods focusing on the deep fascia. The assumption is that fascial manipulation is carried out on precisely determined points -coordination centres (cc), and on a limited area so as the friction occurring during manipulation would cause a local rise in temperature due to the inflammatory reaction. Rise in temperature influences modification in consistency of elementary matter in the manipulated area, and by the same token causing a decrease in the negative effects of fascia densification which stems from accumulation of hyaluronic acid. The purpose of the research is to prove the thesis that fascial manipulation causes local rise in temperature due to inflammatory reaction. Materials and method. For the research, 25 individuals with densification in lower limb area were qualified. They were exposed to a single, 3-minute facial manipulation®. By means of a thermal-imaging camera, changes in the temperature of the body in the examined area were evaluated. The body's temperature evaluation was carried out 8 times: before the treatment, 5 minutes after the treatment, and, next, 6, 12, 18, 24, 36, 48 hours after the treatment. Results. The average surface temperature of the treated area before mobilization was 33.4 °C. A statistically relevant increase in temperature was already observed 5 minutes after the treatment (increase of 0.5 °C; p<0.001). However, the highest temperature was observed 24 hours after mobilization (increase of 2.4 °C). The difference between the first and 7 other measurements was statistically relevant (p<0.001). Conclusion. The statistically relevant increase in temperature under the influence of fascial manipulation® in the treatment area can confirm the occurrence of inflammatory reaction.

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“…There is now emerging evidence that the accumulation of hyaluronan precedes fibrosis in several organs including the lung, kidney, and liver (Bensadoun et al, 1996;Evanko et al, 2015;Jun et al, 1997;Hernnas et al, 1992;Halfon et al, 2005). Although the mechanisms underlying changes in muscle due to mechanical immobilization and spastic paralysis may be different, immobility is a consequence of spastic paralysis, and may trigger a cascade of events that leads to the accumulation of hyaluronan (Stecco et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…It both prevents full passive movement (leading to abnormal posturing that can become fixed over time) and makes active movement more difficult in patients who are already weak from the neurologic injury. Non-neural peripheral mechanisms are thought to cause muscle stiffness (Burke et al, 2013;Stecco et al, 2014), although this has not been shown conclusively.…”

Section: Introductionmentioning

confidence: 99%