Spasticity Management in Persons with Disorders of Consciousness

Area of Science:

• Neurology
• Rehabilitation Medicine
• Neuroscience

Background:

• Spasticity is a frequent neurological impairment in patients with disorders of consciousness (DoC).
• Untreated spasticity can hinder environmental interaction and mask subtle signs of consciousness.
• Lack of specific spasticity data in DoC populations may lead to suboptimal treatment.

Purpose of the Study:

• To characterize spasticity in a large DoC rehabilitation program.
• To evaluate the impact of interventions on spasticity and clinical measures in DoC patients.

Main Methods:

• Retrospective chart review of 146 patients admitted to a DoC rehabilitation program.
• Analysis of spasticity characteristics, affected muscle groups, and interventions used.
• Assessment of outcomes related to spasticity management and consciousness levels.

Main Results:

• 95.2% of DoC patients exhibited spasticity, with 52.7% affected in all four limbs.
• Shoulder internal rotators and ankle plantar flexors were most commonly affected.
• Focal interventions (chemodenervation, ITB) were common; systemic medications were reduced by 50%, correlating with improved consciousness.

Conclusions:

• Nearly all DoC patients experience spasticity, often severe.
• Widespread use of focal spasticity interventions facilitated reduction in systemic medications.
• Reduced systemic spasmolytic medication appeared linked to enhanced levels of consciousness.