Date of Award

1997

Document Type

Scholarly Project

Degree Name

Master of Physical Therapy (MPT)

Department

Physical Therapy

First Advisor

Peggy Mohr

Keywords

Botulinum Toxin Type A -- therapeutic use; Botulinum Toxins -- therapeutic use; Muscle Spasticity; Rhizotomy

Abstract

Following certain types of perinatal or adult-onset brain damage spasticity is the common feature. A persons's disability can be greatly increased secondary to spasticity, which may present a major problem in the restoration of motor function.

Depending on the cause and location of brain injury, the clinical characteristics of spasticity can vary in signs and severity. These varying signs include flexor spasms in the patient with the spinal injury, dystonic posturing in the patient with hemiplegia and spastic diplegia in the child with cerebral palsy. It is apparent that many factors are involved with augmented reflexes and the list of possible sources is incomplete. Spasticity in stroke, spinal cord injury, and traumatic brain injury often interferes with function, limits independence and can result in secondary complications such as contractures. Considering the variety of problems associated with spasticity, it is unlikely that one agent will be beneficial to all patients. Because it takes normal muscle tone and normal control of the tone to give rise to normal movement, therapeutic intervention is often necessary and the type of intervention chosen to treat a person's spasticity is best individualized for each person.

Two treatment methods currently used are Botox injections and selective dorsal rhizotomy. The purpose of this study is to review the literature on Botox injections and selective dorsal rhizotomy in the treatment of spasticity. This information will hopefully aid therapists in making decisions as to possible candidates for each type of treatment.

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