Recognizing and Managing Post-Stroke Spasticity

Strokes occur when an artery is blocked (ischemic stroke) or a blood vessel leaks or bursts (hemorrhagic stroke). Each year, 795,000 Americans experience a stroke that impairs movement, sensation, speech, swallowing, vision, and memory, to name just a few functional changes. Another effect of stroke is muscle stiffness called spasticity when muscles contract involuntarily. Spasticity and muscle weakness are the most challenging and common motor impairments that make treatment and rehabilitation more challenging. Read on to learn more about spasticity following a stroke and what can be done to alleviate it. 

Understanding Muscle Spasticity

Muscles usually move in a pattern where some muscles contract while others simultaneously relax. When the nerves in the central nervous system that control these muscle movements are damaged, it disrupts the pattern, preventing some muscles from relaxing. When the muscles — and sometimes joints — become stiff following a stroke, they cannot stretch, making rehabilitation challenging. 

Spasticity can affect just one muscle or a muscle group and present at any point following a stroke. An estimated 25-43% of survivors experience spasticity in the first year after their stroke, especially for younger people or following strokes caused by brain bleeds. 

Symptoms

Muscle spasticity symptoms include the following. 

• Increased muscle tone
• Stiff fingers, legs, or arms
• Muscles that contract and relax involuntarily
• Discomfort or pain
• Muscle fatigue
• Bone and joint deformity
• Issues with maintaining personal hygiene

Other than negatively impacting the quality of life daily, joints can become locked into place, called contracture, which is when the muscles and tendons permanently shrink and contract causing perpetual stiffness and spasms. 

Managing Spasticity After Stroke

Spasticity is uncomfortable and often painful, but there are ways to alleviate its symptoms, depending on severity. 

Medical Management

Medications

Certain oral or transdermal (patch) medications treat spasticity. These can relax multiple muscles at once, the dosage is easily adjusted and can be stopped if ineffective. However, higher doses are required and subject the entire body to an increased risk of negative side effects.

Intrathecal Baclofen Therapy (ITB)

An ITB pump is programmed to automatically dispense anti-spasm medication implanted in the body. This treatment method is precise with reduced side effects but is expensive and requires surgery. 

Injections

Chemical injections directly target the spastic muscles to block nerves, but this treatment is expensive and loses effectiveness over time. 

Surgery

Surgery may be performed as a last resort to fix contractures, reshape joints, or lengthen muscles. While this is a permanent solution, it is irreversible, expensive, and painful.

At-Home Management

There is no cure for post-stroke spasticity, but incorporating some at-home techniques can help reduce and prevent the occurrence of spasticity following a stroke. 

Exercise and Stretch

Keeping your affected limbs moving following a stroke is one of the most effective things for managing spasticity. Exercising and stretching often in as wide a range of motion as possible helps prevent muscle spasticity, tightening, and shortening. 

Switch Positions

Staying in the same position for too long increases the chances of spasticity, so it is best to switch positions every 1-2 hours to keep muscles and joints from becoming sore or stiff. 

Support Your Limbs

An excellent way to avoid spasticity is to give your stroke-affected limbs enough support, preferably by lying on your back or the side opposite the one affected by the stroke. 

Home Adaptations

Make your homework for you by making changes that make it easier for you to move around and do what you need to, which includes the following. 

• Doorway ramps
• Shower and bathroom grab bars
• Raised toilet seats
• Shower or tub bench
• Adhesive strips in the bathtub 

Mobility Aids

Mobility aids can make getting around easier following a stroke. These include braces, walkers, canes, wheelchairs, transfer aids, and wheelchairs. 

Support Network

Forming a network of family and friends who can encourage you to keep moving and help you perform household tasks can be invaluable for people living with spasticity and their caregivers.  

Functional Electrical Stimulation 

Functional Electrical Stimulation (FES), like the kind achieved with the MyoCycle, can engage paralyzed muscles through exercise, allowing them to relax even after the movement ends. FES tires the muscles while improving blood flow and providing other beneficial side effects such as the following.

• Building muscle and endurance
• Increasing strength and cycling power
• Regaining sensation
• Recovering function
• Increasing or maintaining range of motion
• Preventing bone loss
• Enhancing cardiorespiratory fitness, glucose tolerance, and blood circulation
• Improving self-image and quality of life

MYOLYN Helps Your Muscles Move

Everyone is different, and there is no one-size-fits-all approach to treating and preventing muscle spasticity. However, the caring team at MYOLYN is committed to helping people living with paralysis engage in helpful FES exercises to strengthen muscles and prevent discomfort and pain. Reach out to us today to learn more about our MyoCycle and our resources to help people with paralysis live well following a stroke or other neurological event.