Spasticity: a rehabilitation challenge in the elderly

Area of Science:

• Geriatrics
• Neurology
• Rehabilitation Medicine

Background:

• Spasticity is a major cause of disability in the elderly.
• It often leads to complications and challenges for patients and families.
• Current treatment options are available but require clear goal setting and outcome measures.

Purpose of the Study:

• To outline effective management strategies for spasticity in the elderly.
• To emphasize the importance of a multidisciplinary and goal-oriented approach.

Main Methods:

• Multidisciplinary team approach involving physicians and physiotherapists.
• Patient and family education.
• Pharmacological interventions (oral and targeted).
• Physiotherapy, including positioning and seating.
• Focal treatments like botulinum toxin injections.
• Advanced options: intrathecal baclofen/phenol, surgery.
• Use of specialized garments.

Main Results:

• Early interventions like physiotherapy and oral medications (e.g., gabapentin, tizanidine) can be beneficial.
• Focal treatments, particularly botulinum toxin, are highly recommended and effective for focal spasticity.
• Advanced treatments address more severe cases.
• Lycra garments offer effective management for diffuse spasticity.

Conclusions:

• Managing spasticity in the elderly is challenging for rehabilitation teams.
• A combined, multidisciplinary approach significantly benefits disabled elderly individuals.