Spasticity in post-stroke patients: incidence and therapeutical approach

Abstract Stroke is a leading cause of serious long-term disability: about one third of patients developing spasticity of the affected limbs. Spasticity is characterized by a velocity-dependent increase in resistance to passive movement, and is one of the “positive signs” of upper motor neuron syndrome. Spasticity induces pain, ankylosis, tendon retraction, increasing motor deficit, which may limit the efficacy of rehabilitation methods . Spasticity is also correlated with activity limitations, and reduces quality of life of patients and caregivers. Assessment of post-stroke spasticity requires first clinical examination; scales as Ashworth Modifyed scale and Tardieu Modifyed scale are useful quantitative tools. Treatment of spasticity is often challenging for the rehabilitation team, requiring a multidisciplinary approach. Therapeutic interventions include physical therapy, occupational therapy, use of assistive devices, pharmacological treatment and injectable treatment. Botulinum toxin injections in spastic upper and lower limb muscles have significant effect in reducing muscle tone and improving passive function in affected limbs, and should also be considered for improvement of active function.