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

Video Transcription

Video Summary

The webinar focused on clinical assessment and treatment planning for spasticity, especially in patients with upper motor neuron syndrome after stroke, brain injury, spinal cord injury, MS, and other neurologic conditions. The presenters reviewed the definition of spasticity, common etiologies, and the broader spectrum of UMN signs, including clonus, spastic dystonia, co-contraction, associated reactions, spasms, weakness, and loss of dexterity.<br /><br />A major emphasis was placed on identifying treatment goals in collaboration with the patient and caregiver. Goals may include pain relief, improved hygiene and dressing, better sleep, improved body image, easier positioning, enhanced walking, better hand function, and prevention of skin breakdown. The speakers stressed distinguishing dynamic spasticity from static contracture, and selecting treatment based on whether the problem is focal, regional, or generalized.<br /><br />Several case examples were used to illustrate muscle selection for botulinum toxin treatment, including patterns such as flexed elbow, clenched fist, and equinovarus foot. The presenters highlighted the importance of careful clinical observation, gait analysis when available, and adjuncts such as EMG, electrical stimulation, ultrasound, and diagnostic blocks to improve targeting. They also reviewed treatment options ranging from stretching, splinting, and rehab therapies to oral medications, intrathecal baclofen, neurolysis, and surgery.<br /><br />The talk concluded with practical guidance: treat early when spasticity is symptomatic, set realistic goals, localize the involved muscles carefully, dose appropriately, and follow up to confirm whether patient-centered goals were achieved.

Keywords

spasticity

upper motor neuron syndrome

clinical assessment

treatment planning

botulinum toxin

stroke rehabilitation

muscle selection

dynamic spasticity

contracture

patient-centered goals