The importance of neurorehabilitation to the outcome of neuromodulation in spasticity.
The neuromodulation specialist who is involved in the management of spasticity should not be interested only in the technical aspects of the implantation of a device. It is important that (s)he has a sound understanding of all aspects of this serious disability in order to determine appropriately whether an ablative or a neuromodulatory intervention (intrathecal baclofen administration, spinal cord stimulation, peripheral nerve stimulation) is best for the patient. It is also important that s(he) is able to collaborate effectively with the physiatrists, othopaedic surgeons, neurologists, physiotherapists, neuropsychologists, and care counselors. In this article, we review our approach to the neurorehabilitation of patients with spasticity due to multiple sclerosis, spinal cord injury, cerebrovascular disease or head injury and, on the basis of our experience, we highlight the importance of the integrated management that combines both rehabilitation and neuromodulation methods in order to ensure the maximum benefits for the patients.
Petropoulou
K B
KB
Department of Physical and Rehabilitation Medicine, National Center for Rehabilitation, Athens, Greece. ninapetr@hotmail.com
Panourias
I G
IG
Rapidi
C A
CA
Sakas
D E
DE
D001418:Baclofen / Q000627:therapeutic use*; D004599:Electric Stimulation Therapy / Q000379:methods; D006801:Humans; D015918:Infusion Pumps, Implantable; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000209:etiology / Q000628:therapy*; D010525:Peripheral Nerves / Q000502:physiology / Q000528:radiation effects; D026741:Physical Therapy Modalities; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D001418:Baclofen