title: Management of spasticity revisited.
abstract: Spasticity is common after stroke and other neurological conditions and causes considerable limitations of movement, activities of daily living and participation. Interaction with other components of the upper motor neurone syndrome (UMNS) and the heterogeneity of patients' presentations together with limited tools for outcome measurement have hampered the production of randomised controlled trial data for management strategies. Specialist multi-disciplinary goal-centered management programmes are the mainstay of treatment. Pharmacological therapies have limited effect, and physical and positional management are crucial. Targeted intramuscular botulinum toxin injection is now the most popular pharmacological treatment. Intrathecal therapies also play a lesser role. A team approach and holistic assessment are essential to beneficial outcomes.
authors.affiliation: Neurological Services, Specialist Services Group, Northumberland Tyne and Wear NHS Foundation Trust, Walkergate Park, Newcastle upon Tyne, UK. laura.graham@ntw.nhs.uk
authors.forename: Laura A
authors.initials: LA
authors.lastname: Graham
mesh_terms: D001418:Baclofen / Q000008:administration & dosage; D001905:Botulinum Toxins / Q000008:administration & dosage; D003131:Combined Modality Therapy; D006694:Holistic Health; D006801:Humans; D007273:Injections, Intramuscular; D007278:Injections, Spinal; D009128:Muscle Spasticity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D010276:Parasympatholytics / Q000008:administration & dosage*; D019800:Phenol / Q000008:administration & dosage; D026741:Physical Therapy Modalities; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D010276:Parasympatholytics; D019800:Phenol; D001905:Botulinum Toxins; D001418:Baclofen
keywords: antispasmodics; muscle stiffness; spasticity; upper motor neurone syndrome