The goal of Oakwood's Center for Exceptional Families rehabilitation program is to enhance the quality of life for children with disabilities. We aim to make the most of the child’s potential – both during childhood and later, as an adult. Managing spasticity is one part of our comprehensive pediatric rehabilitation department.

What is Spasticity?
Spasticity is a condition in which some muscles are continuously contracted (shortened and tightened) – causing stiff muscles, awkward movements, and exaggerated reflexes. Spasticity happens when a brain or spinal cord injury damages the nerve signals that tell a muscle to relax. Spasticity may also occur with conditions such as cerebral palsy, traumatic brain injury, stroke, and spinal cord injury.

The degree of spasticity can vary from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms. Spasticity can affect a child’s comfort level and movement, making it difficult to do activities such as sitting, eating, standing, dressing, and walking. Spasticity can also cause contractures, which are fixed, abnormal joint positions that may lead to deformity or the inability to move the related body part.

In addition to spasticity, children with brain or spinal cord injuries may also experience other neurologic (nerve–related) conditions, such as weakness and poor coordination. These other conditions may actually be more disabling than spasticity. Reducing the spasticity may be helpful in these situations, but does not “cure” the condition. In some cases, some spasticity in the legs may help a child stand.

Finally, it is important to note that there are several disorders, other than spasticity, that can cause stiff muscles. Two examples are: dystonia, which may lead to a fixed, abnormal posture; and athetosis, which may lead to uncontrolled movements. Management plans for these conditions will differ from management plans for spasticity.

Things to consider for a spasticity management plan
When making a plan to manage your child’s spasticity at CEF (Center for Exceptional Families), we consider many factors. These factors include:

• Your child’s ability to function in daily life
• The extent (and location) of the spasticity
• Your child’s age and development level
• The condition causing the spasticity
• Other disorders of muscle tone and movement
• The strength of your child’s muscles
• You and your child’s preferences

One spasticity management plan may be best for a child at a young age, while another plan may be better for an older child. Some children may benefit from only one treatment option, while others may benefit from combining two or more. For example, if a child takes medicine to reduce spasticity, physical or occupational therapy may help the child learn how to function with less spasticity.

It is also essential to have a goal! Before recommending any management plan, the care team develops personalized goals for each child. Goals may include:

• Improving hand use
• Improving walking skills
• Improving comfort, ease of care, and positioning
• Preventing muscle contractures and deformities