Life with Spasticity – A Physiotherapist’s Perspective

The impact of spasticity varies from person to person, it could be clinically present but have no impact on your function or it could be a large increase in tone that can affect your quality of life.

What is Spasticity?

Spasticity happens due to a dysfunction of the sensorimotor control, resulting from an upper motor neuron lesion and can present as an intermittent or sustained involuntary activation of muscles- Pandyan et al (2005)

In other words, there is an impairment of pathways of nerves from your brain that would normally control your reflexes and muscle tone. This is often present in various neurological patients such as post stroke, multiple sclerosis, cerebral palsy, spinal cord injury, and brain injury.

What actually happens?

People who live with spasticity may experience physical symptoms such as pain, contractures, clonus and even pressure sores. It can also affect daily function- for example spasticity of the inner thigh muscles can make personal hygiene difficult or spasticity of any muscles in the leg can change the way you walk and make it more effortful. Sometimes due to poor management of the spasticity, you can get caught up in the vicious cycle as shown below:

Flow of Spasticity

How does it affect you?

Many patients that I have met who experience spasticity often tell me that they become fearful of mobility as they don’t feel safe as well as sometimes avoiding social interaction as they are uncomfortable physically and emotionally. They become frustrated and in some severe cases have to rely on carers for daily living which further impacts their quality of life. These can sometimes lead to secondary conditions such as infections, general physical health issues, decrease self-esteem and even cause psychological disorders. 

How can physiotherapy help?

It is important to address the issue of proper timing for the therapeutic management of spasticity. Early intervention is important before soft tissues begin to shorten.  At later stages (more chronic) it is important to look at management techniques to reduce symptoms that can improve or maintain quality of life.

Physiotherapists often look into how they could help their patients stay out of the vicious cycle of spasticity by introducing management techniques such as massage, stretching, splints and exercises to keep the body moving, keep the muscles loose and reduce development of contractures.

Reference: Pandyan AD, Gregoric M, Barnes MP et al. Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil 2005;27:2–6.

About the Author Vanissa Tang

Vanissa is a registered physiotherapist who completed her Masters of Physiotherapy Practice from La Trobe University. Her interest, passion, and experience in both neurological and musculoskeletal physiotherapy provides her with skills and enthusiasm in assisting clients to obtain the best outcomes. She has had a wide range of experience working in a general musculoskeletal and sports therapy private practice, local Victorian amateur footy teams, aged care facilities, as well as community rehab in the home for both spinal cord injuries and conditions associated with the aged populations.