Physiotherapy management of spasticity

doi:10.1017/CBO9780511544866.005

4 - Physiotherapy management of spasticity

Published online by Cambridge University Press: 22 August 2009

Roslyn N. Boyd and

Louise Ada

Edited by

Michael P. Barnes and

Garth R. Johnson

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Roslyn N. Boyd: Affiliation:
Associate Professor, Scientific Director Queensland Cerebral Palsy and Rehabilitation Research Centre, Department of Paediatrics and Child Health, University of Queensland, Brisbane, Australia
Louise Ada: Affiliation:
Associate Professor Discipline of Physiotherapy University of Sydney Sydney, Australia
Michael P. Barnes: Affiliation:
University of Newcastle upon Tyne
Garth R. Johnson: Affiliation:
University of Newcastle upon Tyne

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Summary

In the past, much of the controversy about the management of spasticity has been due to a lack of commonly accepted definitions of the disorder, the difficulty in measuring spasticity as well as the changing nature of the motor activity limitations with growth and maturation. There was also a paucity of data to validate clinical practice. However, there is now a growing body of evidence on which to base clinical practice. While many disciplines are involved in the management of spasticity, physiotherapists have a unique role in applying their understanding of the biomechanics of movement to the analysis of motor activity limitations and their knowledge of motor learning principles to reduce activity limitations. The emphasis of this chapter is on improving muscle performance in order to enable activity rather than preparing the patient for function by affecting abnormal reflex activity. In addition, we discuss the physiotherapist's goal in using orthoses and the role of physiotherapists in pharmacological and surgical interventions. Clinical applications for children with cerebral palsy and adults after stroke are highlighted because these individuals are the largest groups with brain damage.

What is spasticity?

Spasticity is one of the impairments affecting function following brain damage. It is typical to consider the impairments associated with the upper motor neurone syndrome as either positive or negative. Negative impairments are those features that have been lost following brain damage (e.g. loss of strength and dexterity), whereas positive impairments are those features which are additional (e.g. spasticity and abnormal postures) (Jackson, 1958; Landau, 1980; Burke, 1988).

Keywords

cerebral palsy clinical management impairments physiotherapists Spasticity

Type: Chapter
Information: Upper Motor Neurone Syndrome and Spasticity
Clinical Management and Neurophysiology
, pp. 79 - 98

DOI: https://doi.org/10.1017/CBO9780511544866.005 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

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