Spasticity after stroke: physiology, assessment and treatment

Brain Inj. 2013;27(10):1093-105. doi: 10.3109/02699052.2013.804202. Epub 2013 Jul 25.

Abstract

Background: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood.

Method: This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder.

Results: The lack of consensus is highlighted on the basis of spasticity and the associated absence of guidelines for treatment, use of drugs and rehabilitation programmes.

Conclusions: Future studies require controlled protocols to determine the efficiency of pharmacological and non-pharmacological treatments for spasticity. Neuroimaging may help predict the occurrence of spasticity and could provide insight into its neurological basis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Botulinum Toxins, Type A / therapeutic use
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Muscle Spasticity / etiology
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / rehabilitation*
  • Muscle Spasticity / therapy
  • Nerve Block
  • Neuroimaging*
  • Neuromuscular Agents / therapeutic use*
  • Orthopedic Procedures*
  • Orthotic Devices*
  • Parasympatholytics / therapeutic use
  • Physical Therapy Modalities*
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Stroke / complications
  • Stroke / physiopathology
  • Stroke / therapy
  • Stroke Rehabilitation*
  • Transcutaneous Electric Nerve Stimulation*

Substances

  • Neuromuscular Agents
  • Parasympatholytics
  • Botulinum Toxins, Type A