Post-Stroke Spasticity
What is a stroke?
A stroke occurs when the cells of the brain die because they do not receive an adequate blood supply. When the blood flow in the brain is altered or interrupted the brain cells no longer receive vital supplies of the nutrients, oxygen and glucose that they need to survive. Blood flow can be interrupted in two ways; by a blockage of an artery in the neck or brain or by a burst blood vessel that causes bleeding into the brain.
What disabilities can occur following a stroke?
The level and form of disability that occurs following a stroke depends on the area of the brain that has been affected. There are five main types of disability that can occur. These are:
- Paralysis or movement problems (these can be painful)
- Problems with the senses
- Problems with the use and understanding of language
- Memory and thought problems
- Emotional difficulties
What is spasticity and why does it occur following a stroke?
Spasticity is a form of movement disorder. The muscles become resistant to stretch after an injury to the brain or spinal cord. This happens after a stroke because brain cells in parts of the brain involved in movement have died due to a lack of oxygen and nutrients. As a result, the areas of the brain involved in movement do not function properly.
What are the symptoms of post-stroke spasticity?
Patients with spasticity usually experience extra muscle activity, tightness of the muscles and painful muscle spasms. Uncontrolled muscle contractions can prevent patients from performing normal daily activities such as bathing, washing and dressing. They often have fixed clenching of the hand, or opening of the fist. Also, they often have difficulty in getting their arm away from their body. This usually makes it difficult to clean the armpit area. The patient often appears as having an unusual posture. When walking, feet turn inward and on occasion can cross over each other.
What can be done to help patients with post-stroke spasticity?
After a stroke, a patient must try to get back to their normal daily routine. Hospital rehabilitation should start as soon as possible after the stroke. Rehabilitation usually involves specialists, speech therapists, physiotherapists and occupational therapists, as well as support from family and friends. The exact type of rehabilitation treatment that a patient will receive is dependent on the extent and area of the injury in the brain. Rehabilitation treatment is tailored to an individual patient's needs. Walking sticks, braces and wheelchairs can also aid a stroke patient to improve their strength initially and allow them to move around more freely.
Can post-stroke spasticity be treated?
Treatment often involves both rehabilitation and medicines such as tablets or injections. There are five types of treatment that a patient can receive:
- Tablets, which are used to treat the effects that spasticity has on the body
- Injections, which act on the muscles
- Stretching, splinting and casting, which help increase the muscles' range of movement or re-position the affected arms and legs
- Medicine given into the spine
- Surgery, which helps to stop pain and increase the level of movement in the muscles
Useful link to www.stroke.org.uk