Wednesday, September 17, 2014

The management of spasticity in adults

You will notice they say manage, not cure. Dammit expend some intellectual energy and solve the f*cking problem. Point blank ask your doctor what the hell they are doing to solve the spasticity problem.  Screaming in their faces might be useful.  No spitting though. I don't give a damn for their excuse that nothing is clinically proven to work on spasticity. 
Solve it yourself!
http://www.bmj.com/content/349/bmj.g4737?
  1. Krishnan Padmakumari Sivaraman Nair, consultant1,
  2. Jonathan Marsden, professor2
    Author affiliations
  1. Correspondence to: K P S Nair siva.nair@sth.nhs.uk

Summary points

  • Spasticity is a frequent and debilitating feature of common neurological conditions such as stroke, multiple sclerosis, and traumatic brain and spinal cord injuries
  • The disorder is often associated with pain and discomfort and increased care needs
  • Spasticity is difficult to manage and requires a collaborative approach involving multiple disciplines
  • The evidence for both drug and non-drug treatments of spasticity is limited
  • More research is required to determine the effectiveness of various treatments of spasticity
Spasticity is a common disorder affecting people with long term neurological conditions such as stroke, multiple sclerosis, and traumatic brain and spinal cord injuries. A systematic review of 24 studies on the epidemiology of leg spasticity reported a prevalence of 28-38% in patients with stroke, 41-66% in patients with multiple sclerosis, and 13% in patients with traumatic brain injury.1
Spasticity varies from a subtle neurological sign to a gross increase in tone causing immobility of joints. The disorder is associated with several complications, including falls, pain, pressure ulcers, infections, and contractures,2 although it is not clear whether these complications are caused by spasticity or co-exist independently.1 Spasticity increases care needs and utilisation of healthcare resources,3 and carers of patients with spasticity are more likely to experience anxiety and depression.4 Some patients may make use of their spasticity to sit, stand, walk, or transfer. Management of spasticity requires a balanced approach, weighing the benefits of treatment against the usefulness of the spasticity. Current interventions to treat spasticity lack a robust evidence base, and guidelines often depend on expert recommendations. This review discusses the assessment and treatment of spasticity in adults.

2 comments:

  1. For spasticity in my finger flexors, I once got Botox injections. My physiatrist seriously told me that one negative side effect was that my flexors (and grip) would be weaker. WASN'T THAT THE WHOLE POINT??

    ReplyDelete
  2. Oh Doh! There's nothing new to this for me. Solving the problem is the only thing that will work. They are just explaining what it is again. Research options and a cause and cure.

    ReplyDelete