[Guide to the comprehensive treatment of spasticity].
OBJECTIVE
Spasticity is an important medical problem with a high rate of incidence both in childhood, mainly as a result of cerebral palsy, and in adults, which is frequently brought about by traumatic brain injuries, strokes and spinal cord injuries. Spasticity is part of upper motoneuron syndrome, which gives rise to important problems, such as limited joint movement, abnormal postures that can produce pain, impaired functional capacity, aesthetic or hygiene disorders, among others. It progresses naturally towards chronicity, accompanied by static phenomena due to alterations affecting the properties of soft tissues (elasticity, plasticity and viscosity). Numerous therapeutic options are available for the treatment of spasticity, including medication, physiotherapy, orthopaedic aid, surgery, and so forth. Moreover, treatment should be individualised and realistic, with goals that have been agreed between the patient or caregiver and the medical team. The aim of the following guide is to further our knowledge of this condition, its causes, epidemiology and progression, as well as to outline an approach that is both rational and global from the point of view of pharmacological, rehabilitation and surgical treatment.


CONCLUSIONS
Spasticity is a complex problem that requires specialists (neurologist, rehabilitation doctor, occupational therapist, orthopaedic surgeon, general practitioner, etc.) to work as a team in order to achieve the goals set out when treatment is begun. Early treatment is important to avoid or reduce, as far as possible, the severe complications stemming from this condition.
Vivancos-Matellano
F
F
Servicio de Neurología, Hospital Universitario La Paz, 28046 Madrid, Espana. franvivancos@wanadoo.es
Pascual-Pascual
S I
SI
Nardi-Vilardaga
J
J
Miquel-Rodriguez
F
F
de Miguel-Leon
I
I
Martinez-Garre
M C
MC
Martinez-Caballero
I
I
Lanzas-Melendo
G
G
Garreta-Figuera
R
R
Garcia-Ruiz
P J
PJ
Garcia-Bach
M
M
Garcia-Aymerich
V
V
Bori-Fortuny
I
I
Aguilar-Barbera
M
M
D006801:Humans; D001418:Baclofen / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000503:physiopathology / Q000628:therapy; D018450:Disease Progression; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D009465:Neuromuscular Agents / Q000627:therapeutic use; D026741:Physical Therapy Modalities
D001418:Baclofen; D009125:Muscle Relaxants, Central; D009465:Neuromuscular Agents