Neurology-Online

What options are there to resolve spasticity?

introduction

There are many ways to solve or loosen spasticity.

There are several approaches to treatment, including a variety of drugs and surgery. A central element of therapy is always exercise therapy, in the form of physiotherapy and occupational therapy. In addition, aids can have a supportive effect in everyday life. It is also important to bear in mind that spasticity cannot be cured, which can cause confusion with the frequently used term “releasing” a spasticity.

Overview of therapy options for solving and treating spasticity

In order to solve and treat spasticity, methods from different areas can be used. A combination of these is often used.

Physiotherapy remains the basis of all treatments for spasticity. Here, the diseased muscles are set in motion, preventing the spasticity from progressing.

Orthoses can be used if there are significant restrictions in body movements. These help to support and also relieve the strain on spastic muscles. In addition, plaster splints are occasionally put on to slowly stretch severely cramped muscles.

Another therapy option is occupational therapy, in which those affected learn how to cope with their everyday lives and how to use any necessary aids correctly. Various medications are also available as therapy options to relieve the cramps in the muscles caused by spasticity. So-called muscle relaxants from the group of benzodiazepines or anticonvulsant drugs such as gabapentin are used for this purpose. In addition, pain medication may be used for strong spasmodic tension in the muscles.

Finally there is the operative variant. This is mainly used when the disease progresses with increasing restriction of certain joints and muscles.

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Physiotherapy for the treatment of spasticity

In physiotherapy for solving and treating spasticity, the affected muscles and the affected joints are moved.

This tries to maintain certain movements and to keep the body flexible. In addition, in physiotherapy, the affected muscles are stretched through regular exercises. This counteracts excessive tension in the muscles and reduces muscle stiffness and the associated pain.

Which exercises can help?

There are many different exercises that can help relieve or improve spasticity. Above all, depending on the possibility, the focus is on exercises that can be actively carried out by the person concerned.

As a strengthening exercise and also to improve balance, one leg is raised at a 90 ° angle and held in the air for about 20 seconds. You should try to straighten your leg. It is best to stand next to a wall or a chair in order to be able to support yourself in case of balance disorders.

A ball can be used to promote coordination, which is often impaired with spasticity. This is slowly guided around the body with the hands, first 10 times in one direction and then 10 times in the other direction.

Squats can be performed to improve your strength.

It is important that all of these exercises are carried out regularly so that they also bring something to the person concerned in the long term.

Treatment method according to Bobath

The Bobath treatment method is a concept that aims to inhibit pathological movements. These movements are caused by the spasticity.

The Bobath treatment method tries to reduce the spasticity of the flexing muscles on the arms and that of the stretching muscles on the legs. If there is a desire for treatment according to Bobath, a physiotherapeutic practice should be sought where this therapy concept is offered as a treatment option.

Occupational therapy for the treatment of spasticity

Occupational therapy is an important part of therapy for releasing and treating spasticity. Here the focus is on the suitability for everyday use of the person suffering from spasticity.

Various exercises are carried out on the individual characteristics of the disease and the associated impairments in everyday life. They help those affected to carry out certain activities in their everyday life with little or no help. For example, putting on and taking off clothes is practiced. During the exercise, the occupational therapist can also recognize where the weaknesses of the sick person are and deal with them. In addition, techniques are taught that enable independent eating and drinking and also, for example, brushing teeth.

If there is a pronounced form of spasticity, the occupational therapist can also show the corresponding exercises to the person who cares for the person suffering from the spasticity. In addition, the correct use of orthoses and or other walking aids can be practiced.

How can you smooth out a spasticity?

Spasticity can be improved and loosened by stroking the affected muscles. It should be noted that the term "smoothing out a spasticity" does not mean that the spasticity completely disappears when you brush it out. However, certain massage and relaxation techniques can reduce the symptoms in the affected muscles. The stroking should be done by an experienced physiotherapist, who can also show techniques for doing it independently.

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Botox® for the treatment of spasticity

Among the drug therapy options for solving and treating spasticity, Botox® is one of the most effective options. Depending on the severity of the spasticity, amounts of Botox® can be injected into the muscle (intramuscularly) with a syringe. This is done by sticking a syringe with a fine needle directly into the overly active, usually painful muscle. Botox® (actually botulinum toxin) comes in 2 forms. Botulinum toxin A is used in spasticity. This ensures that the neurotransmitter acetylcholine is not released. As a result, information that leads to spastic cramping of the muscles cannot be passed on and the spasticity can be reduced.

After an injection of Botox® into a muscle affected by the spasticity, it usually takes a few days for the effects to take effect and the muscle to relax and relax. The effects of Botox® only last a few months. Then a new injection of Botox has to be given to relax the muscles.