Abstract
Stroke is the third most common cause of death in the Western world, behind heart disease and cancer, and accounts for over half of all neurologic admissions to community hospitals. Spasticity is commonly defined as excessive motor activity characterized by a velocity-dependent increase in tonic stretch reflexes. It is often associated with exaggerated tendon jerks, and is often accompanied by abnormal cutaneous and autonomic reflexes, muscle weakness, lack of dexterity, fatigability, and co-contraction of agonist and antagonist muscles. It is a common complication of central nervous system disorders, including stroke, traumatic brain injury, cerebral palsy, multiple sclerosis, anoxic brain injury, spinal cord injury, primary lateral sclerosis, and hereditary spastic hemiparesis. Leg muscle activation during locomotion is produced by spinal neuronal circuits within the spinal cord, the spinal pattern generator [central pattern generator (CPG)]. For the control of human locomotion, afferent information from a variety of sources within the visual, vestibular, and proprioceptive systems is utilized by the CPGs. Findings of this research can be applied to older adults in longitudinal home care who suffer spasticity caused by stroke.
Highlights
Spasticity decreases with increased volitional movement, but muscle stretch reflexes always remain increased despite total recovery [2]
It is a common complication of central nervous system disorders, including stroke, traumatic brain injury, cerebral palsy, multiple sclerosis, anoxic brain injury, spinal cord injury, primary lateral sclerosis, and hereditary spastic hemiparesis
Six months after a traumatic spinal cord injury (SCI), 2% of subjects graded by the American Spinal Injury Association (ASIA) scale as ASIA A are able to walk at least 25 feet 24 h after onset: this percentage is 30% for those graded ASIA B, and 94% for those graded ASIA C
Summary
It is a common pre-cursor to placement in nursing homes or extended care facilities. Comprehensive rehabilitation may improve the functional abilities of the stroke survivor, regardless of age and neurologic deficits, and may decrease long-term patient care costs [1]. Stroke survivors admitted to inpatient rehabilitation facilities were more likely to return home than those admitted to traditional nursing homes, despite the higher costs. Motor recovery usually occurs in well-described patterns after stroke. Spasticity decreases with increased volitional movement, but muscle stretch reflexes always remain increased despite total recovery [2]. Gait patterns can really only be precisely identified and categorized by threedimensional (3D) gait motion analysis, but two-dimensional (2D) video recording with slow motion replay can greatly enhance routine clinical observation
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