After Stroke or Head Injury, everything changes. Not just for the survivor, but for family, and friends too.


Exercise,balance and walking training are all key elements after stroke, so we'll show you how to get started.


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Managing and treating Spasticity

Andy MacKellar • Apr 09, 2019

Understanding spasticity is key to managing and treating it. Obvious when you say it, but who really does understand it ?

There are lots of medical definitions that describe what spasticity is, but the understanding of why it is, will help far more in it's treatment. So why do people have spasticity is a much better question. I hope this short article will help both patients and physiotherapists, so here goes.

In this I will talk about stroke mostly, as it's by far the most common condition that people have where they experience it . But equally this happens after head injury, and to people with other illnesses affecting the brain and spinal cord. The earliest I have seen this condition appear is within hours after a stroke, so what's going on ?

One traditional view is that spasticity establishes after repeated stimulation of some reflex or response. If we think of a classic picture of a person with a lot of this  high uncontrollable muscle tone in their arm and hand, it's fair to say that it often appears with a substantial effort, such as early attempts at standing.

It also happens after stimulating a particular area of the body, and this could be simply from contact with a sheet or bedding. If that's happening, you would definitely note that as a receptive field. And if you can identify such a field, then working to de-sensitise it is key. Stretch may work, probably if sustained  and  pressure is also a good candidate, which is where pressure garments come in.

We use these a lot, and it's simple to trial. We get a wetsuit... typically a very inexpensive thing to do.. usually around £20 to £40 and cut out the relevant area and apply it every day, for several hours.

Another way is splinting, and the picture above is an example of this. Here we have combined a modern carbon fibre AFO, or ankle -foot -orthosis, with a pair of humble wellies. The wellies provide pressure in the right areas of the foot, keep the splint well aligned and in this case motivate the patient, by helping visualise walking, as she always wore wellies when walking dogs.

Physio for Stroke, Head Injury, Parkinson's Disease, Spinal Cord Injury

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