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RECOGNIZING
POST-STROKE
SPASTICITY

about 1.4 million americans are currently living with spasticity

What is spasticity?
Spasticity is a condition in which certain muscles in the arms and legs involuntarily contract or tense up, which can lead to a range of symptoms your loved one may find painful or uncomfortable:

  • Sudden muscle spasms/twitches
  • Muscle stiffness and tightness
  • Rapid muscle contractions
  • Difficulty moving affected limbs and joints

This condition can make simple movements and tasks difficult or impossible for your loved one—from buttoning their shirt to walking without help.

Use the information in this section to help you learn how to identify spasticity, its impact on your loved one’s daily activities, and how it can be managed.

You can also take a quiz to help you start the spasticity conversation with your loved one and their doctor.

The basics

people use a variety of words and phrases to describe what spasticity feels like:

word cloud
There are 3 types of spasticity, based on how much of the body is affected:
Spasticity Pyramid 2 Spasticity Pyramid 2 Spasticity Pyramid 3
  • upper limb spasticity
  • Spasticity that affects the arms, shoulders, hands, or fingers
  • lower limb spasticity
  • Spasticity that affects the knees, hips, legs, or feet
What causes spasticity? Spasticity results from a disorder or injury affecting the central nervous system (the brain and spinal cord), such as a stroke. Messages sent back and forth between the brain and muscles are disrupted, so muscles don’t know when to contract and relax properly.
SPASTICITY CAN OCCUR WITH MULTIPLE CONDITIONS:

  • stroke
  • 42% of STROKE SURVIVORS DEVELOP SPASTICITY (N = 83)
  • multiple sclerosis (ms)
  • ABOUT 66% OF ADULTS WITH MS STRUGGLE WITH SPASTICITY (N = 2,029)
  • adult cerebral palsy (cp)
  • NEARLY 85% OF ADULTS WITH CP EXPERIENCE SPASTICITY (N = 205)
  • spinal cord injury (sci)
  • SPASTICITY OCCURS IN 65% OF ADULTS WITH SCI (N = 860)
  • traumatic brain injury (tbi)
  • ALMOST 60% OF ADULTS WITH TBI HAVE SPASTICITY (N = 157)

When does spasticity develop?
There is no set time frame in which spasticity can show up. Symptoms may appear shortly after a stroke or it may take weeks or months.

Timeline
The Impact
What does spasticity look like?

Spasticity can result in stiffness in the muscles of the upper limb (shoulder, elbow, wrist, fingers, and thumb) and lower limb (hip, knee, ankle, and toes).

Here are some common signs of spasticity
Flexed wrist
Flexed wrist, curled fingers
FlexedElbow
Flexed elbow
Clenched Fist
Clenched fist
Tight Shoulder
Tight shoulder
Stiff Hip
Stiff hip
Bent knee
Bent knee
Turned in Foot
Turned in foot
Curled Toe
Curled toes

as soon as your loved one shows signs of spasticity, don’t wait!

talk with their doctor right away.

How does spasticity affect everyday life? The increase in muscle tension that comes with spasticity can be painful and debilitating, making even the simplest everyday tasks difficult or impossible, such as:
  • Picking up objects
  • Dressing
  • Walking up and down stairs
People living with spasticity have reported different areas of daily life impacted by their condition*
SPASTICITY AFFECTS EVERYONE DIFFERENTLY

*According to an online survey, percentage of people (N = 810) with spasticity who identified each aspect of their condition as having the most significant impact on their quality of life.

Spasticity affects everyone differently

Be sure to discuss your loved one’s specific problems with their doctor

The Diagnosis
What does spasticity feel like?

Spasticity can lead to a range of sensations, from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms. Because of this, it can be difficult to tell whether or not your loved one has spasticity.

In general, if your loved one has any of the following signs and symptoms, they may have spasticity:

  • Increased muscle tightness, stiffness, or pain
  • Rapid muscle contractions
  • Sudden muscle spasms/twitches
  • Difficulty using or moving their limbs and joints

getting a spasticity diagnosis is a critical step

in helping your loved one manage their road to recovery.

How is spasticity diagnosed?

If your loved one is suffering from symptoms of spasticity, it’s important to talk to their doctor about being evaluated. The doctor may perform several different types of tests to help determine if spasticity is present and how severe it is:

Physical Icon
Physical tests
Measure nerve activity and muscle tightness due to spasticity.
Passive Icon
Passive activity tests
Measure how well your loved one’s joints function when a therapist moves them during exercises.
Functional Icon
Functional tests
Measure your loved one’s ability to move their limbs and perform daily tasks such as walking, dressing, and hygiene. Functional tests also help the doctor assess your loved one’s pain.
Quality Icon
Quality of life tests
Measure impact of spasticity on different areas of daily living, such as dressing, hygiene, and household tasks.

communication is key

It’s important to talk openly with your loved one and their doctor about spasticity.

there were a lot of things that serita was unable to do in terms of independent finger movement and how to make her fingers work together to do certain things.”

–fontessa, caregiver
The Options
What should our spasticity treatment goals be? Once your doctor has diagnosed your loved one with spasticity, the next step is to set specific treatment goals. Treatment goals should be decided through close communication with the doctor and your loved one.
Types of treatment goals to discuss with the doctor
Technical goals
  • Increase range of motion
  • Reduce muscle stiffness/tightness
  • Reduce muscle spasms/pain
Functional goals
  • Improve daily activities and routines
  • Improve limb position
  • Improve walking and other movements
Preventive goals
  • Prevent immobility
  • Prevent pressure sores
  • Delay or prevent surgery
  • Discuss your treatment goals with the healthcare team
  • to help manage expectations
What type of treatment is right for my loved one? Whether your loved one’s spasticity has just appeared or they’ve been dealing with it for some time, there are treatment options that can help. Treatment is usually considered when spasticity interferes with activities of daily living or sleep, causes pain, or leads to more disability.
The main types of treatment for spasticity are:
Physical and occupational therapy icon
Physical and occupational therapy (PT/OT)
Rehabilitation exercises and activities designed by professional therapists to help improve functionality, mobility, and independence.
Injection
Injection therapy
Medications injected into muscles where spasticity has developed to help reduce stiffness/tightness.
Medication
Oral medications
Pills that help reduce muscle stiffness/tightness. These medications relax all muscles in the body, not just the ones where spasticity has developed.
Surgery
Surgery
Medical procedures designed to help reduce muscle stiffness/tightness and pain associated with spasticity.
Specialists often work together as part of a larger healthcare team to not only treat and manage spasticity, but also to optimize your loved one’s continued stroke recovery.
Untreated spasticity can worsen over time and may lead to contracture
Contracture is when a joint becomes permanently fixed in position by stiff muscles.
Talk to a doctor and discuss treatment options at the first sign of spasticity.
spasticity
quiz
Use this 5-point questionnaire to help you start the conversation about spasticity with your doctor
start
Spasticity Quiz
How much muscle stiffness/tightness do you experience during rest, movement, or sleep?
How difficult is it to straighten, bend, or flex your limbs due to muscle stiffness/tightness?
How bad are any muscle spasms/twitches you experience?
Are the muscle stiffness/tightness and/or spasms you experience associated with pain?
Over the past month, how bothersome has your muscle stiffness/tightness and/or spasms been?
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You’ve completed the Spasticity Quiz!

Email or download your responses and take them with you to your next doctor’s appointment. Discuss your symptoms with your doctor and together, you can determine if you have spasticity and what your treatment options may be.

Email my completed quiz

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