Spasticity: The Misunderstood Part of the Upper Motor Neuron Syndrome

@article{Ivanhoe2004SpasticityTM,
  title={Spasticity: The Misunderstood Part of the Upper Motor Neuron Syndrome},
  author={Cindy B. Ivanhoe and Timothy A Reistetter},
  journal={American Journal of Physical Medicine \& Rehabilitation},
  year={2004},
  volume={83},
  pages={S3-S9}
}
Ivanhoe CB, Reistetter TA: Spasticity: The misunderstood part of the upper motor neuron syndrome. Am J Phys Med Rehabil 2004;83(suppl):S3–S9. Spasticity is a sensorimotor phenomenon related to the integration of the nervous system motor responses to sensory input. Although most commonly considered a velocity-dependent increase to tonic stretch, it is related to hypersensitivity of the reflex arc and changes that occur within the central nervous system, most notably, the spinal cord. Injury to… Expand
The phenomenon of spasticity: a pathophysiological and clinical introduction to neuromodulation therapies.
TLDR
The therapeutic management of spasticity is closely related to the aims of rehabilitation; these include avoidance of complications, restoration of movement, re-education of motion and gait, development of self-dependency, and social integration, as well as modification and reorganization of the cortical brain map. Expand
Assessment of spasticity: from EMG to patients' perception
TLDR
The aim of this thesis was to contribute to the development of a comprehensive set of clinically applicable measurement tools for spasticity, using clinical, neurophysiological and biomechanical measurement methods, to support clinical decision making. Expand
How Does Spasticity Affect Patients with Disorders of Consciousness
TLDR
The physiopathology and the current available treatments of spasticity in this specific population of severe brain-injured patients with disorders of consciousness are described. Expand
Spasticity and Upper Motor Neuron Dysfunction
TLDR
This chapter presents an overview of the set of symptoms generally classified as spasticity and suggests the use of a recently presented definition, “disordered sensori-motor control, resulting from an upper motor neurone lesion, presenting as intermittent or sustained involuntary activation of muscles. Expand
SURGICAL MANAGEMENT OF INTRACTABLE SPASTICITY
TLDR
Both neurotomies and dorsal rhizotomies were safe surgical procedures and were provided with good improvement in respect of muscle power, severity of spasticity, patient’s ambulation, gait, range of joint movement, associated pain, functional disability and nerve excitability between both procedures. Expand
Spasticity as the First Manifestation of Ischaemic Lesions Involving the Cingulum
TLDR
The acute destruction of the anterior cingulate region, interrupting inhibitory projections towards lower motor centres, probably explains the acute onset of spasticity that occurred in these two patients with an ischaemic stroke. Expand
The diagnosis and management of adults with spasticity.
TLDR
This chapter will inform the reader about the pathophysiology of spasticity, but also includes the practicalities and principles of management, the delivery of its longer term treatments, and the utilization and measurement of relevant outcomes. Expand
Poststroke spasticity
TLDR
Poststroke spasticity (PSS) can indeed appear immediately after the ictus, but is most often seen later in the course of the illness, and then becomes a marker of changing or increasing sensorimotor malfunction and therefore requires repeated neurologic assessments. Expand
What is the influence of adjunctive therapy on outcome following botulinum neurotoxin (BoNT­A) injection for focal spasticity in adults with neurological conditions?
II Abstract Neurological disorders are the leading cause of disability worldwide. The upper motor neuron syndrome (UMNS) is a common feature of neurological disorders and describes the changes inExpand
Baclofen in the Therapeutic of Sequele of Traumatic Brain Injury: Spasticity
TLDR
Combined treatments must consider the pathophysiology of broader alterations than only excitation/inhibition context, allowing the patient's reintegration with the greatest functionality. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 21 REFERENCES
Clinicophysiologic concepts of spasticity and motor dysfunction in adults with an upper motoneuron lesion
  • N. Mayer
  • Medicine
  • Muscle & nerve. Supplement
  • 1997
TLDR
In the clinical exam, it is important to distinguish between the resistance due to spasticity and that due to rheologic changes, because the distinction has therapeutic implications. Expand
Beyond Ashworth. Electrophysiologic quantification of spasticity.
TLDR
This chapter reviews the basic neuroanatomy and physiology of the stretch reflex and the pathophysiology of the spasticity and current biomechanical and electrophysiological techniques used to quantify spasticsity. Expand
Relation between spasticity and strength in individuals with spastic diplegic cerebral palsy
TLDR
The findings support the literature, which states that individuals with spastic diplegic CP are more involved distally compared with proximally in the lower extremities, and conflict with the Literature, which contains several assumptions that a spastic muscle is a strong muscle and that spasticity causes weakness in the opposing muscle group. Expand
Classification and definition of disorders causing hypertonia in childhood.
TLDR
The purpose of the workshop and this article are to define the terms "spasticity," "dystonia," and "rigidity" as they are used to describe clinical features of hypertonia in children to allow differentiation of clinical features even when more than 1 is present simultaneously. Expand
Relative contributions of neural mechanisms versus muscle mechanics in promoting finger extension deficits following stroke
TLDR
It is argued that persistent and inappropriate flexor activation plays a role in limiting voluntary finger extension, and that this activation is potentially a reflection of altered supraspinal control of key spinal pathways. Expand
Quantitative features of the stretch response of extrinsic finger muscles in hemiparetic stroke
TLDR
The findings suggest that resistance to muscle stretching following stoke is mediated primarily by neurological rather than biomechanical disturbances, although changes in muscle fiber length may exaggerate the resistance. Expand
Do associated reactions in the upper limb after stroke contribute to contracture formation?
TLDR
Even though associated reactions were present in 29% of the subjects during moderate contraction of the contralateral muscles, they were not large, nor were they associated with contracture or spasticity, suggesting that this phenomenon is not usually a major problem for everyday function after stroke. Expand
Collagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity.
TLDR
Examination of muscle connective tissue in children with spastic cerebral palsy suggests that collagen may be involved in increases in muscle stiffness observed in spasticity, and it is suggested that future treatments should consider including prevention of muscle fibrosis. Expand
Deficits in the coordination of agonist and antagonist muscles in stroke patients: implications for normal motor control
TLDR
Results suggest a relationship between spasticity measured at rest and the movement deficit in stroke is suggested by demonstrating a link between motor deficits and control deficits in the central regulation of individual SR thresholds. Expand
Short-term effects of dynamic lycra splints on upper limb in hemiplegic patients.
TLDR
Lycra garments, designed to produce continuous stretch of spastic muscles when worn for several hours each day, have rapid splinting and antispastic effects on wrist and fingers in patients with hemiplegia. Expand
...
1
2
3
...