The positive and the negative impacts of spasticity in patients with long-term neurological conditions: an observational study

Ayoub, Sandy; Smith, Jared G.; Cary, Isabel; Dalton, Catherine M.; Pinto, A. J. Pius; Ward, Claire; Saverino, Alessia

doi:10.1080/09638288.2020.1742803

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…A 15–20% loss of lean body mass delays wound healing [ 31 ]. Additionally, higher levels of injury are associated with neurogenic orthostatic hypotension (NOH) that reduces whole-body tissue perfusion, but also increases the risk of autonomic dysreflexia (AD) [ 32 , 33 ] and spasticity [ 34 , 35 ] that can provoke autonomic sweating and shear, respectively, both of which carry higher risk of pressure injuries. Thermoregulation is also markedly impaired after SCI.…”

Section: Risk Factorsmentioning

confidence: 99%

“…Sibbald and colleagues proposed assessment for critical colonization diagnostic criteria using the acronym NERDS ( n on-healing wound, e xudative wound, r ed and bleeding wound, d ebris in the wound, and s mell from the wound) or STONES ( s ize is bigger, t emperature is increased, o steomyelitis, n ew areas of breakdown, e xudate, e rythema, or e dema, and s mell) for infection, respectively [ 78 , 80 ]. In addition, signs and symptoms of infection include purulent drainage, pain, tenderness, localized swelling, redness, and heat, but also increased spasticity [ 34 , 35 ] and AD for those with SCI above T6 [ 32 ].…”

Section: Wound Infections/osteomyelitismentioning

confidence: 99%

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Pressure Injuries and Management after Spinal Cord Injury

Vecin

Gater

2022

JPM

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Spinal cord injury (SCI) results in motor paralysis and sensory loss that places individuals at particularly high risk of pressure injuries. Multiple comorbidities associated with autonomic, cardiovascular, pulmonary, endocrine, gastrointestinal, genitourinary, neurological, and musculoskeletal dysfunction makes it even more likely that pressure injuries will occur. This manuscript will review the structure and function of the integumentary system, and address the multidisciplinary approach required to prevent and manage pressure injuries in this vulnerable population.

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Section: Risk Factorsmentioning

confidence: 99%

Section: Wound Infections/osteomyelitismentioning

confidence: 99%

Pressure Injuries and Management after Spinal Cord Injury

Vecin

Gater

2022

JPM

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“…Post-stroke spasticity is associated with complications such as contractures pressure ulcers or pain and poor quality of life (18,19). Adequate treatments for spasticity can improve patient function and quality of life (20,21).…”

Section: Geed Et Al Reported Screening and Enrollment Data From The C...mentioning

confidence: 99%

Editorial: Transitional and long-term continuous care & rehabilitation after stroke

et al. 2022

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Editorial on the Research Topic Transitional and long-term continuous care & rehabilitation after strokeStroke incidence and prevalence are increasing, causing substantial socioeconomic burdens and loss of healthy life-years worldwide (1). Timely acute treatment, such as thrombolysis, is crucial to reduce mortality and disability; however, many stroke survivors have to live with disabilities after acute care (1-4). Therefore, continuous rehabilitation and long-term care to meet the needs of individual stroke survivors is mandatory.Establishing novel therapeutics to promote the recovery and management to avoid complications along with adequate rehabilitation in acute and subacute phases is important because the time window for recovery after stroke is limited (5). After adequate intensive rehabilitation, many stroke survivors and their caregivers lack a personalized long-term continuous care plan. Moreover, important information has often not been provided at the time of discharge from acute treatment. Because such need for long-term care is unmet in many cases, subjective and objective outcomes remain unfavorable (6). Therefore, adequate transitional and long-term care strategies and therapeutics to compensate or reduce the effect of impairments after stroke are required.The Research Topic "Transitional and Long-term Continuous Care & Rehabilitation After Stroke" included 14 manuscripts, ranging from a study protocol, case report and observational study to randomized controlled trials, a mini-review, systematic review, and meta-analysis. These timely contributions offer an interesting insight from acute rehabilitation to transitional and long-term care in patients with stroke.

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“…Long-term consequences of spasticity include pain, distorted joint position, posture and hygiene difficulties, and in the long term, permanent joint contractures and deformities [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Reasons and Determinants of BoNT-A Treatment Discontinuation in Patients Living with Spasticity: A 10-Year Retrospective Analysis

Cinone

Santoro

Spina

et al. 2022

Toxins

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Background: The present study aimed to evaluate the reasons and determinants of BoNT-A discontinuation in patients with stroke, multiple sclerosis, spinal cord injury, and traumatic brain injury. Methods: It is a retrospective study of 56 discontinuer patients treated with botulinum toxin between January 2011 and December 2021. Discontinuation rates and their predictors were estimated using Kaplan–Meier, Log rank test, and Cox’s regression method of analyses.Results: The mean age was 56.54 years, 53.57% were affected by post-stroke spasticity, 17.86% by spinal cord injury, 12.5% and 16.07% by traumatic brain injury and multiple sclerosis, respectively. The median discontinuation time was 5 months. The main reason for discontinuation were logistic problems (37%) and orthopedic surgeries or intrathecal baclofen (27%). Discontinuers were more likely to have severe spasticity (R = 1.785), have no pain (HR = 1.320), no access to rehabilitation services (HR = 1.402), and have cognitive impairment (HR = 1.403). Conclusions: The main reasons for discontinuation are related to logistic issues (due to distance or the absence of an adequate caregiver) and surgical interventions for spasticity, including intrathecal baclofen. It is crucial to identify possible predictors of discontinuation to improve the effectiveness of a multidisciplinary management. The study confirms the crucial role of rehabilitation and caregivers in achieving better long-term outcomes.

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The positive and the negative impacts of spasticity in patients with long-term neurological conditions: an observational study

Cited by 9 publications

References 27 publications

Pressure Injuries and Management after Spinal Cord Injury

Pressure Injuries and Management after Spinal Cord Injury

Editorial: Transitional and long-term continuous care & rehabilitation after stroke

Reasons and Determinants of BoNT-A Treatment Discontinuation in Patients Living with Spasticity: A 10-Year Retrospective Analysis

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