Summary
Spasticity is part of the complex clinical picture which results from the upper motor neuron impairment. The underlying mechanisms that produce the automatic overactivity of the muscle groups may manifest themselves as either passive movements dependent on the exerted velocity or persistent muscle overactivity in the form of spastic dystonia. The therapeutic management of spasticity is closely related to the aims of rehabilitation; these include avoidance of complications, restoration of movement, re-education of motion and gait, development of self-dependency, and social integration, as well as modification and reorganization of the cortical brain map. The latter is achieved through long-term learning processes which are subserved by new neurophysiological dynamics, and the mechanisms of neuroplasticity which develop during neural regeneration.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Boviatsis E, Kouyialis AT, Korfias S, Sakas DE (2005) Functional outcome of intrathecal baclofen administration for severe spasticity. Clin Neurol Neurosurg 107: 289–295
Denny-Brown D (1966) The cerebral control of movement. University Press Liverpool, Liverpool
Dewald JP, Pope PS, Given JD, Buchanan TS, Rymer WZ (1995) Abnormal muscle coactivation patterns during isometric torque generation at the elbow and shoulder in hemiparetic subjects. Brain 118: 495–510
Dimitrijevic MR (1993) Spasticity and rigidity. In: Jankovic J, Tolosa E (eds) Parkinson’s disease and movement disorders, 2nd edn. Williams and Wilkins, Baltimore, pp 443–454
Esquenazi A, Mayer NH (2004) Instrumented assessment of muscle overactivity and spasticity with dynamic polyelectromyographic and motion analysis for treatment planning. Am J Phys Med Rehabil 83Suppl: S19–S29
Gracies JM (2005) Pathophysiology of spastic paresis. II: emergence of muscle overactivity. Muscle Nerve 31: 552–571
Handa Y, Naito A, Watanabe S, Komatsu S, Shimizu Y (1986) Functional recovery of locomotive behavior in the adult spinal dog. Tohoku J Exp Med 148: 373–384
Herman R (1970) The myotatic reflex: clinico-physiological aspects of spasticity and contracture. Brain 93: 273–312
Herman R, Freedman W, Meeks S (1973) Physiological aspects of hemiplegic and paraplegic spasticity. In: Desmedt JE (ed) New developments in electromyography and clinical neurophysiology: human reflexes, pathophysiology of motor systems, methodology of Human reflexes. Karger, Basel, pp 579–589
Ivanhoe CB, Reistetter TA (2004) Spasticity: the misunderstood part of the upper motor neuron syndrome. Am J Phys Med Rehabil 83Suppl: S3–S9
Lance JW (1980) Symposium synopsis. In: Feldman RG, Young RR, Koella WP (eds) Spasticity: disordered motor control. Year Book Medical Pubs, Chicago, pp 485–494
Levin MF, Dimov M (1997) Spatial zones for muscle coactivation and the control of postural stability. Brain Res 757: 43–59
Mayer NH (1997) Spasticity and the stretch reflex. Clinicophysiologic concepts of spasticity. Muscle & Nerve Suppl 6: S1–S13
Mayer N, Esquenazi A, Childers MK (1997) Common patterns of clinical motor dysfunction. Muscle Nerve 20Suppl 6: S21–S35
Pierrot-Deseilligny E, Mazieres L (1985) Spinal mechanisms underlying spasticity. In: Delwaide PJ, Young RR (eds) Clinical neurophysiology in spasticity. Elsevier, New York, pp 63–76
Raineteau O, Fouad K, Noth P, Thallmair M, Schwab ME (2001) Functional switch between motor tracts in the presence of the mAb IN-1 in the adult rat. Proc Natl Acad Sci USA 98: 6929–6934
Raineteau O, Fouad K, Bareyre FM, Schwab ME (2002) Reorganization of descending motor tracts in the rat spinal cord. Eur J Neurosci 16: 1761–1771
Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW (2003) Task force on childhood motor disorders Classification and definition of disorders causing hypertonia in children. Pediatrics 3: 89–97
Sherrington CS (1898) Decerebrate rigidity and reflex coordination of movements. J Physiol London 22: 319–322
Sherrington CS (1909) On plastic tonus and proprioceptive reflexes. Quart J Exp Physiol 2: 109–156
Smith AM (1981) The coactivation of antagonist muscles. J Physiol Pharmacol 59: 733–747
Weidner N, Ner A, Salimi N, Tuszynski MH (2001) Spontaneous corticospinal axonal plasticity and functional recovery after adult central nervous system injury. Proc Natl Acad Sci USA 98: 3513–3518
Young RR (1989) Treatment of spastic paresis (editorial). N Engl J Med 320: 1553–1555
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer-Verlag
About this chapter
Cite this chapter
Petropoulou, K.B., Panourias, I.G., Rapidi, C.A., Sakas, D.E. (2007). The phenomenon of spasticity: a pathophysiological and clinical introduction to neuromodulation therapies. In: Sakas, D.E., Simpson, B.A., Krames, E.S. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/1. Springer, Vienna. https://doi.org/10.1007/978-3-211-33079-1_19
Download citation
DOI: https://doi.org/10.1007/978-3-211-33079-1_19
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-33078-4
Online ISBN: 978-3-211-33079-1
eBook Packages: MedicineMedicine (R0)