Spasticity Management After Spinal Cord Injury

Hon, Alice; Kraus, Perri

doi:10.1007/s40141-020-00280-6

Cited by 7 publications

(17 citation statements)

References 101 publications

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“…As above, helping a patient determine potential triggers of their spasticity can assist them to notice more subtle changes which could reflect underlying pathological issues that may need treatment. Identifying potential triggers can help prevent co-morbid illnesses or complications from further reducing quality of life and function of an individual with SCI [ 19 , 20 ].…”

Section: Assessmentmentioning

confidence: 99%

“…These biomechanical modalities in combination with physical therapy can assist in modulating spasticity and have some efficacy in spasticity treatment. However, for many cases, therapy and biomechanical modalities need additional pharmacologic interventions to adequately treat spasticity in persons with SCI [ 19 , 20 , 30 ].…”

Section: Management/treatmentmentioning

confidence: 99%

“…The most common side effects of the anti-spasmodics are sedating qualities with their action on the central nervous system. These medications are usually very good options in cases of generalized spasticity, as they are systemically active, but they may be perceived as causing muscle weakness [ 19 ].…”

Section: Management/treatmentmentioning

confidence: 99%

“…The two main GABA agonists utilized for spasticity are baclofen and diazepam. Baclofen is a GABA B receptor agonist and is probably the most commonly prescribed antispasmodic in all patient populations dealing with spasticity, especially those with SCI [ 19 , 31 ]. Baclofen binds to the GABA B pre- and post-synaptically, causing inhibition of both monosynaptic and polysynaptic reflexes.…”

Section: Management/treatmentmentioning

confidence: 99%

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Spasticity Management after Spinal Cord Injury: The Here and Now

Billington

Henke

Gater

2022

JPM

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Spasticity is a common comorbidity of spinal cord injury (SCI) that is characterized by velocity dependent tone and spasms manifested by uninhibited reflex activity of muscles below the level of injury. For some, spasticity can be beneficial and facilitate functional standing, transfers, and some activities of daily living. For others, it may be problematic, painful, and interfere with mobility and function. This manuscript will address the anatomy and physiology of neuromuscular reflexes as well as the pathophysiology that occurs after SCI. Spasticity assessment will be discussed in terms of clinical history and findings on physical examinations, including responses to passive and active movement, deep tendon reflexes, and other long tract signs of upper motor neuron injury, as well as gait and function. Management strategies will be discussed including stretch, modalities, pharmacotherapy, neurolysis, and surgical options.

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Section: Assessmentmentioning

confidence: 99%

Section: Management/treatmentmentioning

confidence: 99%

Section: Management/treatmentmentioning

confidence: 99%

Section: Management/treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Spasticity Management after Spinal Cord Injury: The Here and Now

Billington

Henke

Gater

2022

JPM

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“…The treatment plan includes a possible, individualized combination of treatment methods: oral medications (baclofen, tizanidine, dantrolene, tolperisone, cannabi noids, diazepam), chemodenervation with botulinum toxin, therapeutic nerve block with ethyl alcohol or phe nol, intrathecal baclofen pump, physiotherapy (passive exercises, stretching), body weightsupported treadmill training, exoskeletal assisted walking, TMS, ultrasounds, cryotherapy, vibration therapy, hydrotherapy, TENS and functional electrical stimulation (FES). Surgical proce dures include tendon lengthening, tenotomy, tendon transfer, neurotomy, selective rhizotomy [28].…”

Section: Spasticitymentioning

confidence: 99%

Long-term complications following spinal cord injuryand aging

Tarnacka¹,

Korczyński²,

Frasuńska³

2020

ppn

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Purpose: The study presents complications following spinal cord injury (SCI) in relation to aging. Views: It is estimated that there are approximately 6 million SCI patients in the world who are struggling with disabilities of the loco motor system of a paraplegic or tetraplegic nature. The effects of aging in a person with SCI are due to age factors related to abnormal health behavior, environmental impact, and the presence of comorbidities and complications. SCI entails numerous complications, the most common including infections of the urinary and respiratory systems, the formation of pressure ulcers, cardiovascular disorders, sleep disorders, depression, muscle atrophy and osteoporosis. In patients who have suffered a SCI, it was found that agerelated changes occur as early as 15 years following the injury, much more often than in the healthy population. The incidence of cardiovascular disease, for example, is 200% higher in people after a SCI than in the general population. It should be emphasized that SCI does occur within the young population, although recently there has been a significant increase in SCI in patients over 65, who as an age group are increasingly fit, and get involved in accidents. Conclusions: The complications of SCI affect the patient's independence and limit his or her activity and functioning in social, pro fessional and personal life. All this implies an assessment of the life quality of patients after a SCI. Also, the prolonged period of a pa tient's lack of independence resulting from osteoporosis, sarcopenia or cardiovascular diseases significantly increases the finan cial burden on the health and social care system.

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