After a stroke, almost 5% of patients are affected by spasticity within 10 days of the event; about 10% of patients are affected after 6 months.2 About one-third of patients with multiple sclerosis have spasticity that limits their ability to perform daily activities.3 Almost 80% of children with cerebral palsy have spasticity.4 Spasticity is evoked with quick passive movement of the affected limb. A "spastic catch" is felt and can be overcome with continued force. The effect is diminished at slower speeds.2 The degree of spasticity is quantified by using the Ashworth scale (Appendices 1 and 2, www.cmaj.ca/lookup/suppl/doi:10.1503 /cmaj.140405/-/DC1). Hyperreflexia is also present in the affected limb. Focal treatment includes stretching, bracing and injection of botulinum toxin.5 Generalized treatment includes proper seating and positioning, medications administered orally or intrathecal injection of baclofen.6 Clinical trials have shown no consistent improvement in ob...

Spasticity

10.1503/cmaj.140405