Spasticity in Focus, Expert Conversations in PM&R: Spasticity Assessment and Treatment Optimization-Session Recording

Video Transcription

Video Summary

The webinar focused on practical evaluation and treatment of spasticity, with emphasis on goal-setting, muscle identification, and treatment planning. After housekeeping notes and Academy updates, the presenters reviewed the definition of spasticity as a velocity-dependent increase in stretch reflexes within upper motor neuron syndrome, along with common causes such as stroke, cerebral palsy, traumatic brain injury, spinal cord injury, MS, and other neurologic diseases.<br /><br />They distinguished positive UMN signs like clonus, co-contraction, spastic dystonia, and spasms from negative signs such as weakness, incoordination, and impaired motor control. Through case videos and polls, they demonstrated how to identify movement patterns in both upper and lower limb spasticity, including flexed elbow, clenched fist, equinovarus foot, and stiff-knee gait.<br /><br />A major theme was that treatment should be goal-oriented and tailored to the patient’s priorities—such as hygiene, positioning, pain relief, walking, grasping, or appearance. The speakers stressed the importance of assessing both dynamic muscle overactivity and static soft-tissue contracture, since each requires different management.<br /><br />Treatment options included splinting, stretching, therapy, oral medications, intrathecal therapy, botulinum toxin injections, and selected surgical or nerve procedures. They highlighted the value of careful clinical examination, gait observation, and selective muscle targeting, with tools such as goniometry, EMG, ultrasound, and sometimes diagnostic nerve blocks. Dynamic EMG was presented as helpful when available, especially for complex gait patterns.<br /><br />The session ended with Q&A, reinforcing that early intervention, clear communication of goals, and precise muscle selection are key to good outcomes.

Keywords

spasticity

upper motor neuron syndrome

goal-setting

muscle identification

treatment planning

stroke rehabilitation

botulinum toxin

gait analysis

contracture assessment

neurologic disorders