Comprehensive Spasticity Management Program
There is no one-size-fits-all answer to spasticity. The most effective treatment plans are customized to individual patients’ symptoms and lifestyles. The Comprehensive Spasticity Management Program offers a full range of treatment options.
Exercise and Body SupportStretching and strengthening exercises can help loosen tight muscles, maintain range of motion and improve motor control. Skilled therapists tailor stretching and exercise plans to individual patients’ needs, and teach the movements to patients and family members. Stretching and strengthening exercises are most effective when done on a daily basis.
Splints, casts or braces may be used to hold spastic extremities in comfortable, functional positions. Adaptive equipment, including wheelchair cushions and padded legs or back rests, can be used to maintain posture.
Often, a combination of exercise and support is recommended. Exercises are used to improve positioning, and splints, casts or braces are used to maintain the new, more functional position.
Skilled TherapyPhysical therapists, occupational therapists and speech therapists offer valuable expertise to patients of the Comprehensive Spasticity Management Program. They help patients maximize movement, plan adaptations and coordinate care with the rest of the treatment team. They also provide a variety of treatments, including:
Electrical stimulation. Small, safe bursts of electrical energy can be applied to strengthen a weaker muscle in order to minimize the effect of a spastic muscle. Electrical stimulation may also help some patients improve motor control.
Partial bodyweight supported treadmill training. Using a sling to support the body, patients who are unable to bear weight can practice walking on a treadmill.
Gait analysis. Therapists carefully monitor and assess patients’ walking movements to determine what interventions and exercises may be most helpful.
Aquatic therapy. Water helps support the body and allows patients to move more freely through a number of appropriate stretching and strengthening exercises.
Oral MedicationsA variety of oral medications can be used to treat spasticity. Some relax overactive muscles. Others interrupt the nerve signals that travel from the brain or spinal cord to the affected muscles. Your doctor will work with you to determine which medication (or medications) might be most helpful. It may take some time to find the most effective combination of medications and other treatments, but your health care team will listen to you and adjust your treatment regimen as needed to give you the best possible outcome.
Temporary Nerve BlocksLocal anesthetics can be used to temporarily block the nerve stimulation of a particular muscle. Physicians may use temporary nerve blocks to identify spastic muscles, and to determine if blocking the nerves effectively improves the patient’s spasticity. If it does, the patient may be a good candidate for a longer lasting nerve blocking procedure. Temporary nerve blocks do not provide long-lasting spasticity control.
Botulinum Toxin Injections and Phenol InjectionsBotulinum toxin and phenol can be injected directly into spastic muscles to provide two to six months of spasticity control. Our Comprehensive Spasticity Management Program performs more botulinum toxin injections and phenol injections than any other health care center in the region, so you can be sure that your treatments will be administered by true experts. Botulisam toxin injections and phenol injections are available at a variety of convenient locations.
Intrathecal Baclofen Pump TherapyBaclofen is a medication that relaxes muscles and reduces muscle spasms, so is commonly used to treat spasticity. Implantable baclofen pumps provide long-term spasticity control with minimal side effects. The pumps, which are implanted surgically into the abdomen, deliver baclofen directly to the spinal cord via a small tube. Because the medication goes straight to the spinal cord, substantially less medication is needed to obtain the desired results than if taken orally.
Our baclofen pump program is the largest, most experienced program in the state, and the seventh largest in the country. That kind of expertise translates into excellent patient outcomes. Our spasticity management experts can help you determine if a baclofen pump is a good alternative for you; if it is, they’ll explain the procedure to you and tailor your dosage to provide maximum movement and control using minimal medication.
Orthopaedic SurgerySometimes, orthopaedic surgery can be useful for people with spasticity. Specialized surgeons can elongate or reposition tendons to increase range of motion for particular patients.
Clinical TrialsBecause our Comprehensive Spasticity Management program is part of an academic medical center, we are able to offer our patients access to new and promising treatments through clinical trials.
Date: July 30, 2012
Online Editor(s): Richard Petre