Turkish Journal of Physical Medicine and Rehabilitation 2006 , Vol 52 , Num 2

Management of Spasticity in Stroke

Belgin Erhan 1
1 İstanbul Fiziksel Tedavi Rehabilitasyon Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, Türkiye

Spasticity should be treated if it interferes with the patient's function, comfort, care and medical status. First of all, nociceptive and  exteroceptive stimuli exacerbate spasticity and they should be eliminated. Stretching exercise, positioning, orthotics, cold treatment, and electrical stimulation were found to be effective in spasticity management after stroke. Oral antispastic agents are the other agents that are used in stroke spasticity. The patient group that gets least benefit from oral antispastic agents is stroke patients. Stroke patients are more sensitive to side effects of oral agents and some of the oral agents may negatively affect the neurological improvement. Because of the side effects of the oral agents, local pharmacological agents become more popular in recent years. Phenol and botulinum toxin A injections were found to be effective in the management. Spasticity management needs an algorithm that is run by a multi-disciplinary team and whatever the treatment choice is, it should be supported by a proper neourorehabilitative programme. 

Keywords : Stroke, spasticity, spasticity management