Management of upper and lower limb spasticity in neuro-rehabilitation

This article reviews the treatment of upper and lower limb spasticity in neurological rehabilitation. Botulinum toxin A proved effective in several placebo-controlled studies reducing muscle tone, easing hand hygiene and nursing, improving upper limb motor functions and gait ability. The effects are reversible and the toxin is well tolerated. Electrical stimulation, tonic stretch post injection and the active use of the treated extremity are means to increase the effectiveness of the costly therapy. Phenol 5% is an alternative in case of budget constraints, but the technique is demanding and side effects are more frequent. Further, task-specific repetitive therapy should follow the successful treatment of focal spasticity in eligible patients to get the maximum profit with regard to disability.