Spasticity is a common consequence of acquired brain injury, affecting up to 38% of survivors. It is characterised by a velocity-dependent increase in muscle tone, resulting in stiffness, involuntary muscle spasms, reduced range of movement, pain, and difficulty with functional movement.
Understanding Spasticity
Spasticity arises from damage to the upper motor neurone pathways that normally regulate muscle tone. Without adequate descending inhibitory control, spinal reflexes become overactive. Left unmanaged, spasticity can lead to serious secondary complications including contracture, pressure injuries, pain, and hygiene problems.
Physiotherapy Approaches
Stretching remains the most widely used physiotherapy technique for spasticity management, maintaining muscle length and preventing contracture. Positioning and splinting are important adjuncts between therapy sessions. Active exercise and functional task practice are increasingly recognised as important components — movement itself has a normalising effect on tone, and functional activity provides the meaningful context that drives neuroplastic change.
References
Harvey, L.A. et al. (2017). Stretch for the treatment and prevention of contracture. Cochrane Database of Systematic Reviews, Issue 1. https://doi.org/10.1002/14651858.CD007455.pub3
Opheim, A. et al. (2014). Upper-limb spasticity during the first year after stroke. American Journal of Physical Medicine & Rehabilitation, 93(1), 12–23. https://doi.org/10.1097/PHM.0b013e3182a51e58
Sheean, G. (2002). The pathophysiology of spasticity. European Journal of Neurology, 9(S1), 3–9. https://doi.org/10.1046/j.1468-1331.2002.0090s1003.x
