This book aids the practitioner in understanding the difference between spasticity and muscle stiffness, weighing old and new treatment options, and developing an appropriate treatment algorithm for a given patient. Spasticity is a common and disabling condition after neurologic injury such as stroke, spinal cord injury, multiple sclerosis, traumatic brain injury and cerebral palsy. Current treatments for spasticity may exacerbate other problems. Hence, there is a great need to develop a comprehensive understanding of the pathophysiology of spasticity and muscle stiffness, its assessment, and the various treatment options available to obtain the best results to restore joint alignment, movement, and function. This book is organized into two sections: Part I of the book deals with the pathophysiology and assessment of spasticity and muscle stiffness, and Part II of the book explains the rationale, framework, considerations, and evidence for various treatments for both spasticity and muscle stiffness. This comprehensive approach will enable physiatrists, neurologists, internists, and physical and occupational therapists to achieve the best possible outcomes for their patients.

Autorentext

Preeti Raghavan, MBBS, is Associate Professor of Physical Medicine and Rehabilitation and Neurology at the Johns Hopkins University School of Medicine and Director of the Center of Excellence for Stroke Recovery and Rehabilitation at the Sheikh Khalifa Stroke Institute. She also directs the Motor Recovery Research Laboratory where she leads a team of researchers to develop innovative therapeutic strategies to enhance recovery after stroke and other forms of brain injury.

Inhalt

PART 1.- 1. Neural basis of spasticity.- 2. Spasticity vs Spastic Movement Disorder.- 3. Clinical Assessment of the Syndrome of Spastic Paresis.- 4. Quantitative Measurement of Resistance to Passive Joint Motion in Chronic Stroke Survivors.- 5. Structural alterations in Spastic Muscle.- 6. Mechanisms of Development of Passive Mechanical Muscle Stiffness.- 7. Symptomatic and Functional After-Effects of the Syndrome of Spastic Paresis.- PART 2.- 8. Framework for the Treatment of Spasticity and Muscle Stiffness.- 9. Medical Exacerbation of Spasticity.- 10. Oral Spasmolytics.- 11. Intrathecal Baclofen Therapy.- 12. Treatment of Focal Muscle Overactivity using Botulinum Toxin Injections.- 13. Treatment of Focal Muscle Stiffness with Hyaluronidase Injections.- 14. Emerging Non-pharmacologic Therapies.