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Title: Assessing and treating functional impairment in post stroke spasticity
Epworth Authors: Olver, John
Other Authors: Sunnerhagen, Katharina
Francisco, G
Keywords: Post Stroke Spasticity
Interdisciplinary Communication
Muscle Spasticity
Quality of Life
Recovery of Function
Severity of Illness Index
Neuromuscular Agents
Activities of Daily Living
Fuctional Status
Epworth Rehabilitation, Epworth Healthcare, Richmond, Victoria, Australia
Issue Date: Jan-2013
Publisher: Wolters Kluwer
Citation: Neurology. 2013 Jan 15;80(3 Suppl 2):S35-44.
Abstract: Poststroke spasticity (PSS) is associated with significant consequences for a patient's functional status and quality of life. Nonetheless, no uniform definition of spasticity exists that can be utilized across clinical research settings, and difficulties in validating proper assessment tools--both clinical and nonclinical--complicate the ability to evaluate and appropriately treat spasticity. Consequently, the current state of defining, assessing, and treating spasticity requires improved consistency and ongoing validation as clinical research efforts advance. When selecting clinical measures for PSS assessment (e.g., the Modified Ashworth, Tone Assessment, Tardieu, Modified Rankin, and Disability Assessment scales, and the Barthel Index), it is critical to understand the levels of impairment or functional limitation each tool assesses as well as their benefits and limitations. The use of quantitative methods--such as electrophysiologic, biomechanical, and imaging techniques--adjunctive to traditional clinical measures also allows for sensitivity in quantifying the abnormal muscle activity associated with spasticity. In addition to accurate evaluation and assessment of PSS, realistic treatment goal setting for patients as well as family members and caregivers is critical, because it promotes motivation and cooperation as well as proper management of expectations and can favorably affect recovery. Goal attainment scaling has been shown to help organize, focus, and clarify the aims of treatment, thereby enhancing the PSS rehabilitative process. Furthermore, integration of therapeutic modalities and treatment strategies, including both nonpharmacologic intervention and pharmacotherapy, is also important for improved outcomes.
DOI: 10.1212/WNL.0b013e3182764aa2.
PubMed URL:
ISSN: 0028-3878
Journal Title: Neurology
Type: Journal Article
Affiliated Organisations: Institute of Neuroscience and Physiology-Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Göteborg, Sweden.
Type of Clinical Study or Trial: Review
Appears in Collections:Neurosciences

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