American Stroke Foundation

Dr. Gregory Herman’s presentation on Spasticity Management. Thank you to The University of Kansas Health System for partnering with the American Stroke Foundation for the Stroke Education Series.

Spasticity falls under the umbrella term of Upper Motor Neuron Syndrome, which can have positive and negative symptoms. In this case, positive and negative symptoms refers to the presence or absence of a symptom.

Positive symptoms include:

• Spasticity
• Muscle overactivity
• Hyperreflexia (overactive muscle reflexes)
• Muscle spasm
• Dystonia (involuntary muscle contractions)
• Rigidity

Negative symptoms include:

• Slowness of movement (bradykinesia)
• Muscle underactivity
• Decreased dexterity
• Weakness
• Paralysis
• Fatigability

Spasticity is a positive syndrome of upper motor neuron syndrome, and is an increase in resistance to a velocity dependent stretch. Oftentimes, quick rapid muscle movements will cause increased muscle spasticity.

• Restricts normal movement
• Excessive/inappropriate movement
• Pain
• Limited function in day-to-day activities
• Tissue damage
• Joint changes/contractures

• Improve mobility
• Decrease pain
• Decrease spasms
• Increase ROM
• Improve positioning

• Stretching
• Splinting
• Electrical stimulation
• Functional activity

Stretching is the first line before all other treatments. Start with therapy and eventually self directed.

When stretching it is important to do all movements slowly and gently and to never force or over-stretch a muscle. A prolonged stretch is the goal with the idea of lengthening the muscle at the end of the range. Relaxation is important throughout the stretch, as it will cause less overall spasticity!