Recovering from muscle spasticity after a stroke

But there is absolutely no need to treat spasticity after stroke. Didn't you get the memo from Dr. William M. Landau? I hope schadenfreude hits him.

Spasticity After Stroke: Why Bother? Aug. 2004 

Recovering from muscle spasticity after a stroke 

There are many aspects to recovery from a stroke, but regaining movement in muscles and joints affected by spasticity is one of the most important for restoring and maintaining quality of life.

by D.F. McCourt

Mar 15, 2018

Chysoula Tsiknis photographed at her home in Burnaby, BC. (Credit: Taylor Roades)

Spasticity is a very common disorder in stroke survivors, causing stiffness, tightness and pain at points throughout the body in up to 40 per cent of patients. For one patient, it can display as a hand that cannot be unclenched from a fist; for another, a stiff knee or painfully pointed foot. For almost all who suffer from spasticity, their daily activities are interfered with, sometimes in minor ways, but sometimes in ways that are quite debilitating. “Spasticity can be a huge burden for patients and caregivers,” says Dr. Rajiv Reebye, a physical medicine and rehabilitation specialist and Clinical Associate Professor in the Department of Medicine at the University of British Columbia. “The stiffness and limited range of motion of their affected limbs can interfere with their activities of daily living, including dressing, bathing, transfers from bed to chair and overall mobility.”
Spasticity can appear very soon after a stroke and can worsen quickly if not treated, progressing within six months to contracture, a permanent shortening of a muscle or joint that results in total joint immobilization. Fortunately, there are a number of treatments available, depending on how promptly intervention takes place.
“It stopped our lives completely”
Chysoula Tsiknis of British Columbia experienced a stroke in November of 2014 that radically changed the shape of the life she had been planning. “I had just retired less than a month earlier and was looking forward to a full life travelling with my husband and enjoying time with our children and grandchildren,” Tsiknis says. “When the stroke happened, it stopped our lives completely. I spent four months in the hospital rehabilitation centre. We had to cancel a trip to Europe that we had been planning, because travel would have been just impossible.”
She developed spasticity first in her arm and then in her toe, causing her pain and frustration. “I couldn’t put on shoes without pain,” she says. “I couldn’t wear the pretty shoes that I like, and that really mattered to me.”
Dr. Reebye emphasizes that complaints that seem small can have a disproportionate effect on a patient’s quality of life in stroke recovery, and that treatment should be guided by the individual’s goals. For Chysoula, he administered a focal botulinum toxin injection in her leg to reduce the overactivity of the muscle controlling her affected toe. “My life has completely changed,” Chysoula says of the procedure. “The pain is completely gone and I can function again. I can wear my pretty shoes and walk and walk.”
“You can get back a lot more than you might think”
Successful recoveries like Chysoula’s are possible for many stroke survivors, but only if they receive the right treatment at the right time. Wrestling icon Bret Hart, who suffered a devastating stroke in 2002 and went on to make an incredible recovery, works with March of Dimes Canada to spread that message far and wide. “I’m very proud of my recovery and I feel so blessed by all the people on the stroke ward team who helped me get my life back,” says Hart. “That’s the reason why, when March of Dimes approached me to be their spokesperson for stroke recovery, I immediately knew that I wanted to help get the message out. And that message is that, if you put your faith in the team, you can get back a lot more than you might think.”
Building awareness that recovery is within reach is essential, especially given how critical the early months are in treating conditions like spasticity. “I’ll never forget how hopeless and helpless I felt in those early days after my stroke,” says Hart. “But the team showed me that, if I worked at it every day, there was always hope for recovery.”
As for Chysoula, her hopes are blooming. She and her husband are finally taking that trip to Europe, where she will walk the streets in her pretty shoes.
If you or someone you know is experiencing muscle spasticity you should consider speaking with your physician.(Why? There is no cure.) If you’re looking for additional resources or have questions, the March of Dimes is dedicated to supporting the post-stroke recovery journey in Canada. Please visit www.marchofdimes.ca to learn more.
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