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Management of Patients With Spasticity - A Practical Approach
  1. Krystyna Walton
  1. Floyd Unit for Neurological Rehabilitation, Birch Hill Hospital, Rochdale and The Greater Manchester Neurosciences Centre, Hope Hospital, Salford, UK; E-mail: krystyna.walton{at}pat.nhs.uk

    Abstract

    Spasticity is one feature of the upper motor neuron syndrome and is therefore common in disorders of the central nervous system. It is characterized by an increase in muscle tone causing resistance to movement that is velocity dependent i.e. it depends on the rate of movement, with sudden high velocity movements causing a greater increase in tone (Lance 1980). Traditionally, the features of the upper motor neuron syndrome are divided into ‘positive’ and ‘negative’ although it should be noted that the ‘positive’ features are not usually positive from the patient’s perspective (Table 1). Spasticity has a characteristic ‘feel’, which the experienced clinician can distinguish from rigidity, and resistance to movement caused by mechanical factors e.g. contracture, joint disorder. The common causes of spasticity are detailed in Table 2.

    This review reflects my own clinical experience in a neurorehabilitation setting, dealing predominantly with spasticity due to acquired brain injury (traumatic and

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