Poststroke spasticity: Treating to the disability

People who have strokes are subject to numerous potentially devastating sequelae, most often sensorimotor paresis, impairment of cognition and language, and other functional disabilities, including depression and dementia. Of these sequelae, spasticity occurring with motor dysfunction is a frequent finding that has to be evaluated in light of other diagnoses, such as central paresis, ataxia, pathologic stance or gait, and other coordination dysfunctions. Often, spasticity is not notably present in acute ischemic strokes but develops later on, and may then become a major obstacle for achieving independence in performance of activities of daily living (ADLs). Spasticity appearing after a stroke demonstrates quite convincingly that stroke is not a stable condition, but must be viewed instead as a dynamic condition that over time can precipitate additional impairments that were not necessarily noted or present in the acute phase. Poststroke spasticity (PSS) can indeed appear immediately after the ictus, but is most often seen later in the course of the illness. It then becomes a marker of changing or increasing sensorimotor malfunction and therefore requires repeated neurologic assessments. PSS can occur coupled with pain, be noted with decreased dexterity or positioning, or simply be associated with a gradual increase in sensorimotor paresis. When occurring late, PSS can induce changes in the entire health perception of the patient and caregiver.
Source: Neurology - Category: Neurology Authors: Tags: INTRODUCTION Source Type: research