Spasticity Management Flashcards
(18 cards)
What is spasticity?
velocity dependent increase in muscle tone
what do mild cases of spasticity look like?
exhibit hyperreflexia
not spontaneously active
what do severe cases of spasticity look like?
loss of function
sleep disturbance
pain
poor quality of life
permanent contractures
postural abnormalities
can electrotherapy help manage spasticity? If so, how?
yes, if you intervene early before long term contractures occur.
produce muscle contractions to re-educate pathways and increase strength
shape of contraction is determined by?
frequency
amplitude
pulse duration
ramp time
why are we concerned with ramp time?
because spasticity is velocity dependent. duh. you want a slow/gradual ramp time
T or F? there is a set optimal parameter to use NMES to treat spasticy
lol false. parameters difficult to define because it depends on the patient
does the literature support NMES for spasticity reduction?
yes, but they use different outcome measures and some look at short or long term effects
what frequency range do we want?
30-50 but up to 100 might be feasible*
greater frequency = greater
fatigue (muscle damage)
why would greater fatigue be a good thing?
want to fatigue so antagonistic muscle can move
what pulse duration
300-500 us
what amplitude
greater than 100mA
what are some ways to use NMES?*
- antagonistic muscle stimulation
- spastic muscle stimulation
- combined agonist and antagonist
- long-term NMES in SCI patients
antagonistic muscle stimulation*
if elbow flexor spasticity, apply NMES to triceps
spastic muscle stimulation*
if elbow flexor spasticity, applied to elbow flexors
goal may be to fatigue, think about increased Hz
will NMES help all spasticity cases?
nope
what are some issues with current lit on NMES and spasticity
- varying outcome measures
- reliability/validity of outcome measures
- heterogeneity of subject pop
- lack of control groups
- variation of stimulation parameters
- patient input required for any treatment
