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Do Physical Modalities Have a Role in Spasticity Management?
Alessandro Picelli1, Rita Di Censo1, Nicola Smania1
1Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Ludovico Antonio Scuro 10, Verona 37134, Italy.
Abstract:
This narrative review examines the potential role of physical modalities in the multidisciplinary management of spasticity, focusing on their physiologic mechanisms, clinical efficacy, and integration with pharmacologic and rehabilitative strategies. It discusses how interventions such as extracorporeal shock wave therapy, electrotherapy, heating methods (ultrasound and diathermy), and vibration therapies (focal and whole-body) target both the neural and nonneural components of spasticity by modulating neuronal excitability and improving muscle rheology. The review also highlights their synergistic effects with antispastic agents, particularly botulinum toxin type A, providing adjunctive mechanisms that can optimize therapeutic outcomes.
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