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Year : 2022  |  Volume : 5  |  Issue : 5  |  Page : 3-22

Module 1: Pathophysiology and assessment of spasticity; Goal setting

1 Department of Rehabilitation Medicine, JFK-Johnson Rehabilitation Institute; Rutgers – Robert Wood Johnson Medical School, Hackensack Meridian Health School of Medicine, New Jersey, USA
2 Neurology Unit, Neuroscience Department, Morgagni-Pierantoni Hospital, Forlì, Italy
3 Department of Rehabilitation Medicine, The Walton Centre National Health Service Trust, Lower Lane, Liverpool, UK
4 Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
5 Department of Physical Medicine and Rehabilitation, La Paz University Hospital, Madrid, Spain
6 Department of Physical Medicine and Rehabilitation, Université catholique de Louvain, Centre Hospitalier Universitaire de Namur, site Godinne, Avenue Docteur G Therasse, Yvoir, Belgium
7 Department of Physical Medicine and Rehabilitation, McGovern Medical School, University of Texas Health Science Center; Department of Physical Medicine and Rehabilitation, UTHealth Houston McGovern Medical School and TIRR Memorial Hermann Hospital, Houston, Texas, USA

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2349-7904.347807

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This module discusses the pathophysiology of spasticity and the lesions underlying the condition. It considers the clinical presentation of spasticity and outlines the relevant clinical history that should be documented. The positive and negative signs of spasticity are explained. Clinical presentations of spasticity are discussed, and an illustrated table of spastic limb postures details how the muscles involved in each individual's condition may be identified. The main systems for assessing the severity of the condition, the Ashworth Scale, the modified Ashworth scale, and the Tardieu Scale, are explained. The likelihood of spasticity developing following a stroke and the probable long-term outcomes are considered. The value of involving patients in their own treatment regimens, by defining and setting goals, using the SMARTER system is explained, and the need to continually assess and refine treatment with time as the condition progresses is also discussed.

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