I wrote this 3 years ago, nothing in it has really changed. Ask your doctor about this stupidity, its the only way we will get this researched.
Sorry about ranting on spasticity. I guess if I look at it objectively I
have a mild form, it is just that if I was truly paralyzed and only had
to recover function instead of suppressing spasticity/tone first and
then work on the paralyzed muscle it would be much easier. I have done
both baclofen and zanaflex which didn't help the spasticity at all, just
made me tired so I quit them. I have had several rounds of botox which
helped with knocking out my bicep so my tricep could start working.
Finger flexors were also knocked out but since my finger extensors need
to move control to a different spot in my brain that didn't result in
any improvement.
Found an interesting site Movement Disorder Virtual University that
has lots of detail on spasticity. Here is the link
http://www.mdvu.org/library/disease/spasticity/spa_mpath.asp
If you follow it down quite a few levels you can find this
Subject: Incidence and Consequences of Spasticity After Stroke
Date: 2/20/2004
Spasticity affects less than one quarter of stroke victims, according to this study.
Muscle overactivity and its consequences were assessed in 95
patients both immediately after and three months a first-time stroke.
Seventy-seven (81%) were initially hemiparetic, of whom 20 had
spasticity. Among these 20 patients, 14 had hyperreflexia. Within these
patients, 3 had clonus, and 3 had muscle stiffness. Modified Ashworth
score was grade 1 in 10 patients, grade 1+ in 7, and grade 2 in 3. None
had grades of 3 or 4. At three months, 64 patients (67%) were
hemiparetic, and 18 spastic, reflecting 5 whose tone normalized and 3
who became spastic in the interim. The correlation between muscle tone
and a range of motor and activity scores was low for most measures at
both time points, except for active movements initially, and rapid
movement scores and 9-Hole Peg Test scores at three months.
The authors conclude, “spasticity seems to contribute to motor
impairments and activity limitations and may be a severe problem for
some patients after stroke,” but, given the relatively low numbers of
patients with spasticity, they note, “Our findings support the
opinion…that the focus on spasticity in stroke rehabilitation is out of
step with its clinical importance. (What the hell? - (they wouldn't say this if they
had to recover from spasticity.
Basically since only 25% of stroke survivors have it and most seem
to be able to do ADL's, clinical research seems unlikely. So we are on
our own unless we can somehow change that mindset. I really disagree
with these authors, I want to recover everything , not just good enough
for my ADLs
As a final comment, my ADL's are just fine. If I can get past the
spasticity I can start doing all the normal stuff I did pre-stroke which
is why I am extremely interested in this.
Posted in 6 stroke forums with no positive answers
One would think that you should be able to interrupt the signals telling
your muscles to fire. This is why eStim seems stupid, you are sending
electrical signals to the antagonist muscles hoping to fire them
stronger than the spastic ones. Why not send electrical signals to your
spastic muscles telling them to relax? Or do we not know this and need to research it?
"I want to recover everything, not just good enough for ADLs." This is exactly my sentiment. I have been lucky, my stroke was smallish, I am youngish,....whatever...I can do most ADLs, but I want to be all better. I'm on my own too and have been for a long time. Stroke rehab sucks!! Happy holidays!!
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