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Author: Admin | 2025-04-28
And muscle hypertonia defined as a velocity-dependent resistance of a muscle to stretching [1]. Spastic muscle tone can in one other way be distributed in flexor and extensor muscles in addition to a focal or generalized enhance in muscle tone may be skilled relying on the reason for the spastic signs [2]. In this chapter, we relate the definition of spasticity by Lance [1] to the knowledge of the mechanisms underlying the related movement disorder. On the premise of the clinical signs it was assumed up to now that neural overactivity, causing exaggerated reflexes, might be responsible for muscle hypertonia, which then leads to spastic movement disorder [6�10]. This view was supported by experiments on decerebrate cats [[11], which confirmed that muscle tone throughout stretching is considerably reduced after severing the nerves involved within the stretch-reflex loop. Therefore, it turned established that most treatment approaches ought to be directed to attenuate or abolish reflex activity and thereby to reduce muscle tone [6, 12]. Correspondingly, human tendon tap reflexes are enhanced on the affected facet already early after stroke with out improve in muscle tone. Second, exaggerated tendon reflexes are solely a small a half of the mechanisms that contribute to the management of practical movement, corresponding to walking. Third, most studies on the impact of antispastic drugs are centered on isolated medical signs, corresponding to reflex exercise, and never on the spastic movement dysfunction that hampers sufferers. No convincing animal mannequin exists for human spasticity (see [13]), maybe as a end result of the pathophysiology of spasticity is multifactorial. Any changes within the neuronal or biomechanical methods, for instance variations within the website and period of a central lesion, are of importance in determining which neural control mechanisms are poor and contribute to the motion disorder [14]. Furthermore, such modifications might already be secondary and compensatory to the primary dysfunction of sensorimotor methods. There are some differences in the look of spasticity between spinal and supraspinal lesions and lesions of different origin. Research on functional movement in latest years indicates that the scientific indicators of spasticity are little associated to the spastic motion disorder, which hampers patients and should be the primary target of any remedy. For example, exaggerated reflexes, a dominant sign in medical assessments, have little impact on the movement dysfunction. In this chapter, we describe the position of reflex and muscle exercise and muscle mechanics in patients
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