A Review of Spasticity Treatments: Pharmacological and Interventional Approaches

Crit Rev Phys Rehabil Med, 2013 · DOI: 10.1615/CritRevPhysRehabilMed.2013007945 · Published: January 1, 2013

Simple Explanation

Spasticity is a condition characterized by increased muscle tone and uncontrolled contractions, often resulting from damage to the central nervous system. The goal of spasticity treatment is to alleviate symptoms, allowing individuals to live with minimal discomfort and limitations while avoiding significant side effects. Treatment options include medications (oral agents), injections (Botox, phenol/alcohol), and surgical interventions, each with its own benefits and risks.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review article

Key Findings

1
Baclofen is considered a first-line treatment for spasticity, especially in adult spinal cord injuries, acting as a GABAB agonist to reduce muscle excitability.
2
Botulinum toxin injections are widely used for focal spasticity, providing localized relief without the systemic side effects of oral medications.
3
Intrathecal baclofen (ITB) delivers baclofen directly to the spinal cord, allowing for higher concentrations with fewer systemic side effects, and can be particularly effective for lower limb spasticity.

Research Summary

Spasticity, characterized by increased muscle tone and involuntary contractions, results from conditions affecting the central nervous system and can significantly impair daily activities and quality of life. Treatment strategies involve oral medications, interventional procedures like botulinum toxin injections and intrathecal baclofen, and surgical options, aiming to relieve pain and improve function. A multidisciplinary approach combining medication, physical therapy, and rehabilitation is essential to manage spasticity, reduce tone, and improve functional motor control and independence.

Practical Implications

Personalized Treatment Plans

Assess each patient's medical history to determine the best treatment option, considering both the benefits and risks of oral agents versus interventional therapies.

Multidisciplinary Care

Integrate medication, physical therapy, and rehabilitation to optimize outcomes, reduce spastic tone, and improve functional motor control.

Further Research

Conduct more studies to determine optimal intrathecal baclofen dosing strategies and catheter tip placement, as well as to investigate the effectiveness of combination therapies.

Study Limitations

1
Many treatments still need further research to prove their efficacy and develop optimal utilization.
2
Limited sample sizes in studies assessing the effectiveness of implantable devices.
3
Potential adverse effects concerning bladder, bowel, and sexual function with certain treatments.

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