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Spasticity and Contracture (I) – Physiotherapy Management

What is Spasticity and Contracture?

Spasticity

Spasticity is a common condition seen in elders who suffered from stroke, head or spinal injury. It is induced by over-activity of muscles when the central nervous system is damaged. Spasticity is characterized by muscle stiffness, pain, loss of range of joint movement and muscle strength. It also affects the elders’ mobility and activities of daily living. Spasticity can be reduced with proper care and treatment such as physiotherapy, occupational therapy, medication and surgery. If left untreated, spasticity might lead to joint contracture.

Contracture

Remember Contracture is a common complication seen in bedridden elders or those who are physically inactive. The muscles, ligaments and connective tissues surrounding an inactive joint will become shortened. Fibrosis of the joint may occur, leading to damage of the cartilage. Contracture can greatly affect the elders’ mobility and activities of daily living. It can be preventable by proper care, physiotherapy and occupational therapy.

Physiotherapy For Spasticity and Contracture:

Through the guidance and supervision of physiotherapists, carers and elders can practice the following measures to prevent and reduce the problems caused by spasticity and contracture, so as to increase the elders’ mobility.

Positioning: The risk of developing pressure sores can be reduced by using pillows with good support, applying proper positioning skills in sleeping, sitting and standing postures, and changing position regularly.
Heat therapy /
Cold therapy:
Heat therapy can help to reduce spasticity and muscle fatigue, and soothe.chronically painful joints. Cold therapy is used in acute joint inflammation (i.e. the affected part is red, hot, swollen and painful).
Rehabilitation: Elders can improve their mobility by actively participating in rehabilitation exercises such as muscle strengthening and balance training exercises.
Passive range of motion: Passive range of motion exercise, administered either manually or through specialized equipment, which can maintain the joint range of motion and increase the extensibility of muscles.
Stretching: Stretching can help sustain or improve muscle length and decrease spasticity
Electrical therapy: Electrical therapy applied together with rehabilitation exercise can reduce spasticity, joint and muscle pain, and prevent loss of muscle strength.

Tips for Caring for Elders with Spasticity and Contracture

  • Handle the elders with care, and do not forcefully pull their limbs. Otherwise, it may lead to pain and fractures.
  • Prevention is better than cure. Once contracture has developed, it is very hard to treat. Hence, it is important to prevent it by regular physical activity and proper positioning. Rehabilitation, passive range of motion, stretching and electrical therapy should only be performed under the supervision of physiotherapists.