HOW TO CLINICALLY ASSESS AND TREAT MUSCLE OVERACTIVITY IN SPASTIC PARESIS

被引:61
|
作者
Yelnik, Alain P. [1 ]
Simon, Olivier [2 ]
Parratte, Bernard [3 ]
Gracies, Jean Michel [4 ]
机构
[1] Univ Paris 07, AP HP GH Lariboisiere F Widal, Dept Phys Med & Rehabil, F-75010 Paris, France
[2] Univ Paris 07, AP HP GH Bichat, Dept Phys Med & Rehabil, F-75010 Paris, France
[3] Univ Franche Comte, CHU Besancon, Dept Phys Med & Rehabil, F-25030 Besancon, France
[4] Univ UPEC, AP HP CHU H Mondor, Dept Phys Med & Rehabil, Creteil, France
关键词
spatstic paresis; muscle; overactivity; assessment; treatment; UPPER-LIMB SPASTICITY; TOXIN TYPE-A; BOTULINUM-TOXIN; DOUBLE-BLIND; INTRATHECAL BACLOFEN; STROKE; EFFICACY; THERAPY; PATHOPHYSIOLOGY; HYPERTONIA;
D O I
10.2340/16501977-0613
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
This educational paper aims to describe in adult patients, the different aspects of muscle overactivity after a central nervous system lesion, including spasticity spastic dystonia and spastic co contraction the assessment 01 then symptoms and consequences, and therapeutic options Discussion and Conclusion Clinical evaluation involves the assessment of passive range of motion, angle of cane!: or clonus, act's e range of motion, rapid alternating movements and functional consequences A number of scales have been des eloped to assess patients with spastic paresis involving both patient and elapse's Not all persons with spasticity require treatment which is considered only when muscle overactivity its is disabling or problematic. A list of personal objectives may be proposed for each patient, which will drive assessment and treatment Prim to treatment the patient must be informed of the intended benefits and possible adverse events Clinical evaluation may be supported by the use of transient neuromuscular blocks and/or instrumental analysis Physical therapies usually represent the mainstory of treatment Self rehabilitation with stretching and acme exercises, intramuscular injections of botulinum toxin, alcohol or phenol injections oral or intrathecal drugs, and surgery comprise the treatment options available to the elf in hollow up must be scheduled in order to assess the benefits of treatment and possible adverse events.
引用
收藏
页码:801 / 807
页数:7
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