Reduce post-stroke spasticity
Reduce post-stroke spasticity
 

Up to 13% of stroke patients develop disabling spacticity1

Together we can reduce spasticity for these patients.


What is disabling spasticity?

Spasticity

Spasticity (muscle tone) is best described as ‘disordered sensorimotor control resulting from an upper motor neuron lesion, presenting an intermittent or sustained involuntary activation of muscles.’ – 2005 SPASM consortium definition2

Severe disabling spasticity

Spasticity is defined as severe when it is problematic for the patient or caregiver. It is defined by functional or comfort limitation rather than solely by numerical rating.

 


Recognising the signs

Patients’ muscles are tight and stiff, which makes movement difficult or uncontrollable. They also have painful muscle spasms that interfere with activities of daily living.

Recognising the signs

Spasticity is a burden on patients, caregivers and payers


What are the treatments for spasticity?

Conventional treatments

Oral medication

Oral medication
Used until not effective any more or creates intolerable side effects

Oral medication

Physical therapy
Used alone or alongside conventional and advanced treatments

ADVANCED TREATMENTS

Oral medication

Injectable treatments
Generally used for focal spasticity, i.e. in one limb only

Oral medication

ITB therapySM
Learn more here

Oral medication

Surgical procedures
Irreversible procedures to treat spasticity, e.g. neuroctomy, myeloctomy, rhizotomy


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ITB THERAPYSM


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1

Dvorak EM, Ketchum NC, McGuire JR. The underutilization of intrathecal baclofen in poststroke spasticity. Top Stroke Rehabil. 2011;18(3):195–202.

2

Pandyan AD, et al. Spasticity: Clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil. 2005;27:2–6. 

3

Saulino M, et al. Best Practices for Intrathecal baclofen therapy: Patient selection. Neuromodulation. 2016;19:607–15. 

4

Gillard PJ, Sucharew H, Kleindorfer D, et al. The negative impact of spasticity on the health-related quality of life of stroke survivors: a longitudinal cohort study. Health Qual Life Outcomes. 2015;13:159. doi:10.1186/s12955-015-0340-3.D

5

Welmer et al. Spasticity and Its association with functioning and health-related quality of life 18 months after stroke. Cerebrovasc Dis 2006;21:247–53

6

Denno MS, Gillard PJ, Graham GD, et al. Anxiety and depression associated with caregiver burden in caregivers of stroke survivors with spasticity. Arch Phys Med Rehabil. 2013;94(9):1731–6. doi:10.1016/j.apmr.2013.03.014.

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Lundström E, Smits A, Borg J, Terént A. Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: the first year after the event. Stroke. 2010 Feb;41(2):319–24. doi: 10.1161/STROKEAHA.109.558619

8

Barnes MP, Johnson GR. Upper motor neurone syndrome and spasticity: Clinical management and neurophysiology. Cambridge University Press, 2008.

9

Penn RD. Intrathecal baclofen for spasticity of spinal origin: seven years of experience. J Neurosurg. 1992;77(2):236-240.

10

Meythaler JM, Guin-Renfroe S, Law C, et al. Continuously infused intrathecal baclofen over 12 months for spastic hypertonia in adolescents and adults with cerebral palsy. Arch Phys Med Rehabil. 2001;82(2):155-161

11

Ivanhoe CB, Francisco GE, McGuire JR, et al. Intrathecal baclofen management of poststroke spastic hypertonia: Implications for function and quality of life. Arch Phys Med Rehabil. 2006;87(11):1509-15.

12

Schiess MC, Oh IJ, Stimming EF, et al. Prospective 12-month study of intrathecal baclofen therapy for poststroke spastic upper and lower extremity motor control and functional improvement. Neuromodulation. 2011;14(1):38–45

13

Creamer MC, Cloud G, Kossmehl P, et al. Intrathecal baclofen therapy versus conventional medical management for severe post-stroke spasticity: Results from a multicentre, randomised, controlled, open-label trial (SISTERS). J Neurol Neurosurg Psychiatry. 2018 Jan 11. pii: jnnp-2017-317021. doi: 10.1136/jnnp-2017-317021.