Treatment of muscle spasticity after cerebrovascular accident

The article is professionally consulted by Master, Specialist Doctor I Nguyen Thi Thanh Binh - Rehabilitation Doctor - Department of General Surgery - Vinmec Da Nang International General Hospital. The doctor has 30 years of experience in the specialty of Rehabilitation.

Spasticity can affect voluntary movements in people with partial paralysis, making it difficult for patients to carry out daily activities. Spasticity after a stroke also causes discomfort or pain to the patient and is the cause of contractures, deformation and disability, so it is necessary to treat and restore spasticity to limit complications.

A cerebrovascular accident, also known as a stroke, is a condition in which a part of the brain is suddenly damaged when a blood vessel supplying that part of the brain is blocked or ruptured. This condition causes the brain to be deprived of oxygen, brain cells die after only a few minutes and every minute that passes, there will be nearly 2 million brain cells dying, making the patient lose life time about 3 weeks.
One of the complications of a cerebrovascular accident is muscle spasticity. This is an increase in muscle tone that is dependent on the rate of stretching accompanied by an exaggerated increase in tendon reflexes. The cause of this condition is an overstimulated muscle reflex arc, spasticity is one of the disorders of the upper motor neuron injury syndrome.
Spasticity can affect voluntary movements in people with partial paralysis, making it difficult for patients to carry out daily activities. Spasticity after a stroke also causes discomfort or pain to the patient and is the cause of muscle spasm, joint deformity, disability, so it is necessary to treat and restore spasticity to limit complications.

The goal of spasticity rehabilitation after a stroke is to help the patient perform daily activities such as eating, dressing, walking,...
Duration 3 - 6 months After the stroke is the golden time for the patient to recover spasticity. The sooner a person recovers, the better chance they have of regaining lost abilities. Methods of rehabilitation of spasticity after stroke include:
Treatment of muscle spasticity after a stroke with physical therapy and movement therapy:
Standing on a rotating inclined table Stretching exercises Regularly to prevent contractures and maintain joint range of motion Splints or casts cycle maintain position to inhibit stretch reflex of contractile limb and prevent contracture Electrical stimulation: percutaneous stimulation, stimulation neuromuscular, spine therapy Treatment of muscle spasticity after stroke with drugs:
Baclofen (Lioresal); Diazepam (Valium); Dantrolene (Dantrium); Tizanidine (Zanaflex); Clonidine (catapres)

Local treatment:
Nerve block with Phenol 5% Injection of Botulinum toxine group A or B. Combination treatment of Botulinum toxin and Phenol to increase effectiveness Treatment of muscle spasticity after stroke by surgical methods:
Intrathecal Baclofen pump; Pulpectomy or mastectomy; Orthopedic methods: stretching, releasing or transferring tendons; Selective resection of the posterior fascia in children with cerebral palsy, bone surgery to correct deformities is a method of treatment for spasticity after cerebrovascular accident.

Cerebrovascular accident has a recurrence rate of 25% in the first 5 years after treatment. Therefore, patients need to actively prevent disease by:
Building a healthy lifestyle: Having a healthy lifestyle is a method to limit stroke, so patients need to stay away from stimulants, do not smoke, drink alcohol,... At the same time, do not stay up late, avoid stress or overwork. Good control and treatment of diabetes, hypertension, fat disorders, cardiovascular diseases...

Diet: Eat a lot of green vegetables, fresh fruits to increase resistance. Limit foods high in cholesterol. Do not eat spicy or too salty foods, processed foods such as pickles, salted onions, smoked meat, pate, sausages.