Physiotherapy to Reduce Spasticity: Definition, Causes, and Exercises

What Is Meant by Spasticity?

Spasticity is described as the disruption of muscle patterns that cause the muscles to contract all at one time when the person tries to make some movements or even at rest. The muscle-contracted muscles interfere with the movements and affect speech and gait. Spasticity varies from mild tightness of the muscles to severe pain in the affected body parts. It may also cause uncontrollable spasms and stiffness of the limbs.

Spasticity may be accompanied by muscle spasms, hypertonicity of the muscles, clonus, pain, abnormal posture, contracture of the muscles, deformities of bone, muscles, and joints, muscle tightness, difficulty in activities such as bathing and dressing, and also sleep disruption. Usually, muscle movements are controlled by a complex system of the brain to contract and relax. So damage to the central nervous system can affect muscle movements. As a result, the muscle may contract all at one time. This is sometimes called coordination.

What Are the Conditions That Cause Spasticity?

Spasticity is caused by neurological conditions that damage the pathways of the nerves within the spinal cord and brain. The various neurological disorders include:

• Cerebral palsy (disorder affecting the ability to move).

• Stroke (poor blood flow of the brain causing cell death).

• Spinal cord injury.

• Head or brain injury.

• Multiple sclerosis (degenerative disease of the brain and spinal cord).

• Lou Gehrig's disease (Amyotrophic Lateral Sclerosis).

• Krabbe disease (buildup of harmful amounts of lipids in the body).

• Hereditary spastic paraplegias (weakness and stiffness).

• Phenylketonuria (deficiency in the enzyme phenylalanine hydroxylase).

• Adrenoleukodystrophy (ALD) (damage to the membrane covering the brain and the spinal cord).

What Are the Exercises That Help to Reduce Spasticity?

Physical therapists usually recommend weight lifting and stretching exercises to reduce the spasticity caused by various neurological conditions. The exercises include

1. Shifting the Body’s Weight - The instructions are:

• The person should sit on a chair with the back straight, slowly shift their weight to one side, and hold the position for several seconds.

• Then the person should move their weight back to the center, slowly shift it to the opposite side, and hold the position for several seconds.

• Then the person should repeat the exercise six to ten times on each side.

2. Ball Squeeze - This exercise helps in reducing the spasticity of fingers. The instructions are:

• The person should hold a small therapeutic ball in the palm of their affected hand.

• Then the person should wrap their fingers over the ball and squeeze it.

• Then the person should hold the squeeze for a few seconds and relax.

• The exercise can be repeated up to 20 times for two sets.

3. Shoulder Blade Protection - This exercise helps in reducing the spasticity of hands and arms. The instructions are:

• The person should sit on a chair and extend their arms in front at the level of the shoulders.

• Then the person should clasp their hands and bend their neck slightly forward.

• The position should be held for a few seconds when the person feels a stretch.

• The exercises should be repeated 6 to 10 times.

4. Ball Pinch - This exercise improves the person's ability to grip an object easily. The instructions are:

• The person should pick a therapeutic ball with the affected hand and hold it between their thumb, middle finger, and index finger.

• Then the person should gently squeeze the ball with the tips of the three fingers.

• Then the person should hold the squeeze for several seconds and repeat it up to 20 times.

5. Supported Reach and Grasp - This exercise helps to increase the ability to reach the objects in front of the person. It also helps to build strength in the elbow, wrist, and shoulders. The instructions are:

• The person should sit up straight on the chair in front of a table and rest the affected arm of the table straight out.

• Then the person should extend their arm, hand, elbow, and fingers forward to reach an object.

• Then the person should make a fist at the longest point of the reach and bring it to the starting position.

• The exercise can be repeated up to 20 times.

6. Wrist Curls - This exercise helps improve the wrist's strength and fine motor skills of a person. It helps the person to perform activities like brushing, using scissors, and holding a pen easily. The instructions are:

• The person should sit in a chair near a table, place the elbow of the affected hand on the table, and extend the forearm forward.

• Then the person should place a bottle filled with water on the affected hand.

• Then the person should support the affected hand by gripping its wrist with the opposite hand.

• Then the person should slowly curl the water bottle using their wrist and extend it down and back.

• The exercise can be repeated four to five times.

7. Knee Extensions - This exercise helps the person walk safely and reduces the risk of falls-related injuries. The instructions are:

• The person should sit straight in a chair with bent knees and flat feet on the floor.

• Then the person should extend their left foot as if kicking a ball in front of them.

• Then the person should slowly move their foot back to the floor.

• Then the person should repeat the exercise on the opposite leg, which can be repeated 4 to 5 times on each leg.

8. Side-Lying Hip Flexion - This exercise helps to reduce the spasticity of the hip muscles and helps the person prepare to walk and roll over surfaces more easily. The instructions are:

• The person should lie on the floor with their unaffected side. The person should ensure that their hips are stacked directly on each other.

• Then the person should bend the knee of the leg at the top and move the leg towards their face above the hip angle.

• The person should straighten their leg and place it on top of the other leg.

• The exercise can be repeated 15 to 20 times.

Conclusion:

Spasticity caused by neurological conditions may also cause muscle spasms, muscle stiffness, and pain in the affected muscles. As a result of spasticity, the person finds difficulties in performing daily activities like walking, speaking, etc. Physiotherapy to reduce spasticity helps to regain the range of motion and strength of the muscles. These exercises also help to improve mobility. The best treatment is to contact a physical therapist to reduce the spasticity caused by various medical problems.