Understanding and Managing Spasticity in Poststroke Rehabilitation: Harmony Sierens, MD

WATCH TIME: 5 minutes

"Spasticity is a word that most people have never heard of, but it means it's a stiffness in the muscle—a velocity-dependent resistance to movement. With poststroke spasticity, you have to stretch. It is your medicine that you cannot miss and you have to take every day. Educating patients about potential poststroke spasticity and closely monitoring its development are crucial, as spasticity can manifest in diverse ways impacting individuals' daily lives."

Poststroke spasticity, a common complication, is associated with other signs and symptoms of the upper motor neuron syndrome, including agonist/antagonist co-contraction, weakness, and lack of coordination. These symptoms combined may result in impairments and functional issues that can predispose to costly complications for patients seeking treatment. According to a review previously published in Stroke, researchers suggest that the goal of managing poststroke spasticity should not only consider the reduction of muscle hypertonia but also the impact of the condition on function and well-being.¹

Treatment interventions recommended by clinicians for patients with poststroke spasticity typically focus on peripheral and central strategies, including physical techniques to increase muscle length like stretching and pharmacological modulation. Despite limited comparative studies on the superiority of one method over another for poststroke spasticity, researchers have found that optimal management involves a combined and coordinated compendium of therapies.¹ These combined recommendations for care encompass cost-effective pharmacological and surgical interventions as well as rehabilitative efforts for patients.

Harmony Sierens, MD, a physiatrist, recently sat down in an interview with NeurologyLive® to discuss how spasticity manifests poststroke, and why early awareness and education is essential for patients. Sierens, who also serves as the medical director at Ascension Genesis Inpatient Rehab Unit, spoke about the role that stretching plays in the management of poststroke spasticity, and why it is considered a crucial component of treatment. Additionally, she talked about how healthcare professionals effectively monitor and intervene early in cases of spasticity after brain or spinal cord injuries.

REFERENCES
1. Francisco GE, McGuire JR. Poststroke spasticity management. Stroke. 2012;43(11):3132-3136. doi:10.1161/STROKEAHA.111.639831