What is spastic movement disorder ("spasticity")?
Spasticity is a movement disorder resulting from disinhibited spinal reflexes resulting from damage to the upper motor neuron and dysregulation of the efferent inhibitory pathways, and is associated with an increase in the velocity-dependent stretch reflex, which is also reflected in an increase of muscle tone.*
* Trompetto C, Marinelli L, Mori L, et al. Pathophysiology of Spasticity: Implications for Neurorehabilitation. BioMed Res Int. 2014;2014:354906. http://downloads.hindawi.com/journals/bmri/2014/354906.pdf, last accessed on April 1, 2022.
Characteristic features of spasticity
Approx. 270,000 strokes per year.
Heuschmann PU, Busse O, Wagner M et al., Stroke frequency and care of stroke patients in Germany. Akt Neurol 2010; 37(07): 333-340.
Approximately 20 to 40% of all stroke patients develop a spastic movement disorder within a year
Potempa C et al., On the care situation of patients with spastic movement disorders in Germany. Health Services Research Monitor 03/2019. 12th year 04.06.2019.
Stroke is a major cause of disability in adulthood
Murray CJL, Vos T, Lozano R et al., Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2197–2223
About 6% of stroke patients are permanently dependent on inpatient care
Potempa C et al., On the care situation of patients with spastic movement disorders in Germany. Health Services Research Monitor 03/2019. 12th year 04.06.2019.
Three main factors are responsible for functional limitation and disability in spastic paralysis:
1. Paresed.
that is, decreased voluntary responsiveness of skeletal motor units.
2. Contracture of soft tissues, especially muscle shortening with joint misalignment
3. Hyperactivity of muscles
that is, decreased ability of muscles to relax
Rehabilitation ➤ As early as possible
BoNT physio: stretching/strengthening
Symptoms ↘︎
Motor function ︎↖︎
Independence ︎ ↖︎
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