Evidence Based Practice - Spasticity Flashcards Preview

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Flashcards in Evidence Based Practice - Spasticity Deck (12)
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Why should 24 hour posture management be used and how?

Prevention of STS and contractures

Improves extensibility of tissues

Use of pillows and supports


What is a prolongued stretch? How to apply? What is the effect?

Stretch for 20-30 minutes through splints or casting

Increases extensibility of tissues and provides viscoelastic changes to the soft tissues


How can tone be modulated in spasticity?

Rotational movements, TENS, Weight-bearing and FES

Causes input via the vestibular system which increases the descending inhibition


What is a manual stretch and when should it be applied?

20-30s holds, complete prior to and during exercise to increase extensibility

Start as a passive stretch - then progress to active stretches and task-specific stretches


What should be avoided with spasticity?

Noxious stimuli
High velocity movements


Why should exercises include dynamic aROM?

Prevent STS and minimise loss of movement


What kind of principles can be applied for dynamic aROM exercises?

- Slow and controlled active movements
- Decrease friction to make it easier
- Funcitonal exercises


What are the medical management options for spasticity?

- Spinal cord injections of baclofen or phenol
- Oral medications to block excitation in ascending or descending tracts - e.g. baclofen or gabapentin
- Surgical tendon release


What type of outcome measure is goniometry?

impairment-based to show STS


What is the validity of goniometry?

Poor inter-rater validity due to palpation of bony points, and lack of stabilisation when goniometry is placed


What is the reliability of goniometry?

Consistency of results can vary but improved by:
- same goniometer
- positioning
- procedure
- tester


When to complete goniometry?

Repeat before and after the physio session once a month