Saturday News

Contents of This Week: Saturday News ▶︎ February 20th / 2016

• Definition: Spasticity

Spasticity (from Greek spasmos-, meaning "drawing, pulling") is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles. Clinically, spasticity results from the loss of inhibition of motor neurons, causing excessive muscle contraction. This ultimately leads to hyperreflexia, an exaggerated deep tendon reflex. Spasticity is often treated with the drug baclofen, which acts as an agonist at GABA receptors, which are inhibitory. A longer definition comes from Wikipedia. 

• Video: Spasticity
• Spasticity: Loosen Up
• Stroke and Spasticity: The Recovery Process
• How a Baclofen Pump Works
• Treatment for Severe Spasticity from Stroke
• Physical Therapy for Spasticity
• UPDATE Spasticity-Toomer, MD
• Fighting Spasticity After Stroke
• Teaching - Spasticity - Causes of Limitation & Opening Hand
• Teaching - Opening a Spastic Hand
• Botox for Post-Stroke Spasticity

• Headline Blog: Spasticity
• Rebirth?
• Such a Spaz
• Choosing to Work Towards Happiness
• 4 Treatment Options for Spasticity
• Spasticity
• Are Resting Hand Splints a Waste of Money?
• Brain Stimulation Might be Viable Post-stroke
• I'm a Spaz
• An Arm Recovery Stroke Advance? @Fightingstrokes
• After Stroke, Spasticity is a Bad Thing—but Things Could be Worse.

• Weekly Columnists
• Musing: What's the Reason for Stroke Spasticity Drugs?
• Sunday Stroke Survival: Spasticity Revisited
• Caregiver: Goodbye, Bobmobile
• Jester: Whatever Happened To...
• TED Talks - Jocelyne Bloch: The Brain May be Able to Repair Itself -- With Help

• Eclectic Stuff on Wednesday
• Shameless plug for me and the Edmonton Public Library Writer in Residence
• Where Have I Been for Nine Days?
• Aspirin Desensitivity: I'm One of the 2%
• 50 Shades of Tips
• Rick Mercer Report: Glass Blowing & CBC News Promo
• Laid-Back Admin: No Post This Week
• XKCD: Gravitational Waves

• Future Topics in SSTattler

     Saturday News | Future Topic
     --------------+---------------------------------------------

     Mar/19/2016   | Anomic Aphasia
     Mar/12/2016   | Speech Repetition
     Mar/05/2016   | Accessible Housing
     Feb/27/2016   | Webcomics

Definition: Spasticity

Spasticity From Wikipedia, the free encyclopedia

SSTattler: Please look at original  Saturdays News - Spasticity and Stroke June 30th, 2012. Some of YouTubes is new. Three most difficultly and suffering stroke are 1) paralysis 2) spasticity and 3) fatigue. 

Spasticity - stiffness in the arms, fingers or legs.

Spasticity (from Greek spasmos-, meaning "drawing, pulling") is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles.

Clinically, spasticity results from the loss of inhibition of motor neurons, causing excessive muscle contraction. This ultimately leads to hyperreflexia, an exaggerated deep tendon reflex. Spasticity is often treated with the drug baclofen, which acts as an agonist at GABA receptors, which are inhibitory.

Spastic cerebral palsy is the most common form of cerebral palsy, which is group of permanent movement problems that do not get worse over time. GABA's inhibitory actions contribute to baclofen's efficacy as an anti-spasticity agent.

Cause

Spasticity mostly occurs in disorders of the central nervous system (CNS) affecting the upper motor neurons in the form of a lesion, such as spastic diplegia, or upper motor neuron syndrome, and can also be present in various types of multiple sclerosis, where it occurs as a symptom of the progressively-worsening attacks on myelin sheaths and is thus unrelated to the types of spasticity present in neuromuscular cerebral palsy rooted spasticity disorders.

Video: Spasticity

Spasticity: Loosen Up

Published on Apr 17, 2015

Spasticity is a post-stroke condition that can cause limited coordination and muscle movement and painful muscle spasms in your arms and legs. Stroke survivors identify spasticity as one of the top three most prevalent post-stroke conditions.


Standard YouTube License @ NationalStrokeAssoc

Headline Blog: Spasticity

Definition: Blog (noun). Add new material to or regularly update to a blog. (≃1990s: blog shortening of weblog)

Rebirth?

Barb Polan
Barb's Recovery

Posted 3rd January 2012 

I know that some survivors consider the day of having a stroke as a "rebirth" into the world - becoming a new person infused with gratitude for a second chance, having a fresh way of looking at everything previously taken for granted. They celebrate "rebirthdays." I, for one, do not look that way at having had a stroke. To me, having had a stroke meant the death of my old life, not the birth of a new one. Sure, there are things that are better now: my focus professionally now is on being a writer, not being an editor because I couldn't sell enough of my writing; I have concrete proof that I am well-loved by my family and friends; I know that the hard work, determination and strength of character that my recovery has required can all be diverted to some other worthy task once my rehab is complete; I can accept that "what happened is what happened and [for me anyway] is not likely to happen again," to paraphrase Bartholomew Cubbins, of "500 hats" fame. That does make the stroke I had the beginning of a new phase of my life? Does that mean I was "reborn" after all?

Often, when I wander through semantics and my personal experiences like this, I end up with many questions and few answers - just like being in adolescence over again. And learning to walk makes me 1 again, while redeveloping my reasoning skills puts me at 7 or 8. And, because of the spasticity in my hand, I still can't crawl; although I can get on my hands and knees, keeping my fingers curled. Not being able to tie my shoes, use a knife to cut my food, or zip my coat puts me pre-kindergarten, right?

Such a Spaz

Marcelle Greene
Up Stroke

Sunday, June 19, 2011

When I was a kid, one of my favorite expressions was "Don't have a spaz," which I would say to someone who had lost emotional control. I didn't know it then, but spaz is a derivative of "spasticity," which is a common result of stroke. It describes a state of continuous, uncontrollable muscle contractions.

Absent the proper signals from my brain, my fingers clench into a fist. My arm curls toward my chest. My foot turns inward, pulled by tight muscles along my inner leg. My chest constricts like a steel band around my lung. Sometimes it's hard to breathe.

I am on two types of medication to counteract this problem – daily oral baclofen and quarterly Botox injections. They both ease but do not eliminate the symptoms.

My therapists tell me that I can learn to control the spasticity. For each movement, I concentrate on extending one set of muscles then contracting the opposing muscles. To straighten my arm, I focus on relaxing my bicep then recruiting my tricep. It's exhausting mental and physical work. I sometimes break a sweat just moving a can of tomato paste.

My no-longer neurologist told me that I'd be fighting spasticity the rest of my life. I'm not sure how that statement is supposed to help me. As someone who cultivated flexibility during 10 years of yoga, the idea of spending the next 30-plus years with half my body contracted totally makes me have a spaz.

See the original article:

Such a Spaz

in

Up Stroke

Choosing to Work Towards Happiness

Leslie
Living After Stroke

Derailed Plans

We walked out of a restaurant last night after being seated. Well, I rolled.

There’s a new Indian restaurant in my small town. The sign said buffet. It was only at lunch and the dinners were $20+ a plate. Not in our budget at all.

We would have paid that as a splurge for the buffet. Not because we wanted a ton of food but because we wanted to try a variety of dishes.

Neither of us has ever eaten at an Indian restaurant. We thought it was the perfect opportunity to be introduced. We were scared to order a $20+ dinner and not enjoy it. Maybe one day we’ll make it there for the lunch buffet.

So out we went. It was a small place. Getting in and out of a booth and into my chair was awkward and noticeable.

We ended up having a wonderful Mexican dinner al fresco.

Surprising Reaction

I’m not gonna lie, I was disappointed; I was looking forward to a new experience. Plus, just putting on shoes instantly triggers spasticity and increases pain. When we first left the house, it was hot & uncomfortably humid. Getting in and out of the car twice and chair 4 times was more than I bargained for at the end of a long day. Every transfer is scary and painful.

4 Treatment Options for Spasticity

Ramon Florendo
Life After a Stroke

Wednesday, January 21, 2015

(first Posted by Emily Shearing Jan 07 2015)

Exercise can help with post-stroke spasticity.If your muscles are unusually tight and you have difficulty getting around or performing simple tasks after a stroke, you’re not alone. Estimates show that half of all stroke survivors struggle with spasticity.

Stroke often causes muscles to spasm uncontrollably, much like having a charley horse. Because the muscle isn’t properly stretching, the stiffness caused by spasticity can eventually lead to muscles shortening and settling in an unnatural and sometimes painful position.

As with most forms of stroke therapy, the sooner you begin treatment, the more likely you are to recover. Below are four options to treat spasticity. Be sure to have a conversation with your doctor to determine what’s best for you.

Exercise

Regular physical activity and daily stretching of the affected limb is often the first and most effective form of treatment for spasticity.

Oral Medications

Spasticity

Amy Shissler
My Cerebellar Stroke Recovery

July 9, 2012

I haven’t posted anything significant for a week so I thought I’d write about spasticity although I have none.  A cerebellar injury will not cause spasticity.  Most strokes however will cause spasticity.  Spasticity is a velocity dependent tone to the muscle.  So what does that mean?  That means that a muscle, say your bicep, is always contracted and “on.”  So your elbow is always bent.  It attacks some muscles more than others.  The velocity dependent part means it gets worse the faster it is moved.  I remember the very first patient we touched in PT school had spasticity.  She was incredibly open to us touching her arm but we were all scared to do it.  It’s nerve wracking putting your hands on a patient for the first time.  Now I have no physical boundaries with people, I have no problems touching people.  :)  That sounds weird.  Anyway, spasticity occurs in degrees and can be very painful.  Imagine your elbow constantly bent – that would hurt.  Treatment from a physical therapy standpoint is to keep that muscle as long as possible with very slow stretching and range of motion.  Also, you’d want to strengthen this muscle – and the opposite muscle.  So if the spasticity is affecting your bicep you’d want to get the tricep really strong.  I’m glad I have no spasticity, I think it would be very hard to deal with.  If you have it, it will get better as the brain heals.

Related articles:

• Spasticity (whatishyponatremia.org)
• A Guide to Stroke Rehabilitation (handtutorblog.wordpress.com)

See the original article:

Spasticity

in

My Cerebellar Stroke Recovery

Are Resting Hand Splints a Waste of Money?

Rebecca Dutton
Home After a Stroke

May 1, 2014

Studies of resting hand splints make me cringe when researchers ask the wrong questions. Studies done by Lannin (1) and Burge (2) asked if resting hand splints improve functional hand use. A resting splint that places the hand in one static position does not retrain the brain.

So it is not surprising that Lannin and Burge found resting hand splints produced no significant improvement on hand function tests, like the Motor Assessment Scale.
           
Lannin (1) also concluded "splinting has little or no effect on the loss of range of motion" (p. 113) because both subjects who did and did not wear a resting splint lost some wrist range of motion (ROM). Unfortunately, Lannin told therapists treating subjects who were wearing a resting splint to stop all passive stretching and restrict active hand exercises to 10 minutes a day.

I asked a different question. What would happen if I continue to do passive stretching and active hand exercises, but stop wearing my SaeboFlex resting splint at night? After a month of not wearing this splint it felt like my thumb was getting tighter. I resumed wearing this splint and the next morning I woke up with a ferocious ache in my thumb. Every night that I wear my splint I wake up with no resistance to thumb ROM although my thumb is tight by the evening. I don't think my resting splint has eliminated my spasticity, but I believe it has prevented a contracture.

Brain Stimulation Might be Viable Post-stroke

Jeff Porter
Stroke of Faith

Tuesday, October 08, 2013

Image from the
National Institutes of Health

Stroke recovery can be a challenge - many, many know that better than I - but it's good to see research on possible ways to improve that recovery.

A recent study discussed how
brain stimulation is viable in post-stroke rehab:

▶ Repeated noninvasive transcranial magnetic stimulation (nTMS) helped treat spasticity, motor symptoms, and post-stroke pain in a small population of stroke patients, researchers reported here.

Check out the link for the whole story, and keep in mind the research included a small number of people. Still, this bears watching.

See the original article:

Brain Stimulation Might be Viable Post-stroke

in

Stroke of Faith

I'm a Spaz

Grace Carpenter
My Happy Stroke

Saturday, June 8, 2013

When I was in junior high, whenever a friend did something clumsy, awkward, or funny, we would laugh and say,

"Don't be a spaz!"

I think I vaguely knew that the word "spaz" came from "spastic," but I had no idea what spasticity actually meant. Until, of course, I was afflicted with this uncomfortable condition myself.

Looking back, one of the people who probably suffered from spasticity was a kid in my class who had spina bifida, or maybe cerebral palsy. He used crutches and his legs looked like they hadn't grown enough. Other than noticing his awkward gait, I didn't think about him at all. My top--and only--priority in junior high was to fit in.

There was also an adult in our neighborhood who probably had spasticity. He walked into the town center every day with a lopsided gait. I'm guessing that he also had Tourette's syndrome, because he also used to mutter curses, and jerk with uncontrollable tics. "He's harmless," my mother would reassure me, if I encountered him on my walk home.

A few weeks ago when I was walking, I had a good view of my shadow. I was trying to walk fast, which makes my spasticity more noticeable. I was swinging my right arm, and with each step I could see my shadow arm moving in jerky, awkward movements, like a wind-up toy losing steam.

At first I was amused by my spastic shadow. I was even tempted to spew curses, just to see reactions of passers-by.

Then I thought: please god, help me walk normally before my children start junior high.

(For the record: I believe I also have apraxia, which contributes to the awkward look of my movements. Like many stroke survivors, I have a cluster of conditions.)

See the original article:

I'm a Spaz

in

My Happy Stroke

An Arm Recovery Stroke Advance? @Fightingstrokes

Kate Allatt
Stroke Recovery Tips

August 23, 2014

Ever since my own discharge from hospital in 2010, I was convinced that electrical stimulation (ES) was in part responsible for helping restore life to my paralysed left arm.

I was sure my totally ‘paralysed-but-with-sensation’ left arm responded well to the experimental ES treatment I received. I believed it actually helped REWIRE my brain.

It got me thinking, ‘Just think if it was offered to all suitable stroke survivors & was applied early, frequently and repetitively enough, then more people could restore arm function post any type of stroke.

ES (not to be confused with functional electric stimulation FES) or a high powered, inexpensive TENS type machines are usually available over the counter and could make a ‘Neuroplasticity difference’ I think.

Furthermore, can ES perhaps reduce pain and contractures too? We need proper stroke recovery initiatives, not just stroke prevention marketing messages.

In the 3.5 years running my charity – Fighting Strokes – I am more convinced than ever by this technology after looking back over all my Facebook comments:

I used TENS (transcutaneous electrical nerve stimulation) on my right arm also as this is my weaker side.’ Allison O’ Reilly, 52 Brainstem Stroke survivor diagnosed and recovered from locked in syndrome.

After Stroke, Spasticity is a Bad Thing — but Things Could be Worse.

Peter G. Levine
Stronger After Stroke

Saturday, May 7, 2011

Flaccidity is an example of a point in the poststroke arc of recovery with consequences as bad, or worse, than spasticity. Spasticity carries with it the potential for contracture, pressure sores, pain, joint problems and deformities. Flaccidity, too, carries obvious physical risks (i.e., subluxation, muscle atrophy, etc.). But flaccidity also provides an ominous window onto the prognosis of the limb. Flaccidity says 2 things: “Recovery will have to wait” and/or “Recovery may have ended”.

There are two kinds of paralysis; flaccid paralysis and spastic paralysis. Most of the patients therapists see fall into neither category. Part of the reason that therapists typically don't see truly paralyzed patients is because, traditionally at least, little can be done to help. With the advent and broadening use of intrathecal baclofen, injectable neurolytics and the dorsal root rhizotomy, etc., the potential for treatment has broadened. Still, most of the people that are candidates for treatments that aim to improve limb movement are not going to be hemiplegic (paralyzed) -- they'll be hemiparetic (weak). The question becomes, is there more potential and somebody who has near flaccid or spastic?

Weekly Columnists

Definition: Columnist |ˈkäləmnist| (noun). A blogger or a journalist contributing regularly to a blog or newspaper

Musing: What's the Reason for Stroke Spasticity Drugs?

Dean Reinke
Deans' Stroke Musing

Sunday, April 17, 2011

This is only my theory, so be sure to ask your doctor for his/her explanation. There is a great hope that by giving general muscle relaxants the antagonist muscle has enough power to overcome the spastic one. This also makes the assumption that the antagonist muscle control is only partly damaged and not dead. Botox or phenol basically paralyze one muscle while at the same time hoping that the antagonist is only damaged. This is a completely trial and error guess by your doctor because they have never come up with a specific damage diagnosis and thus are not able to compare cases against each other. They are completely flying blind.

This one is interesting for what it eventually says - FDA Approves Gablofen.

This is just another way to deliver baclofen, similar to the baclofen pump. This line from the article is key; and the need for intrathecal baclofen therapy is life long since it does not cure the cause of spasticity. Remember none of the drugs for spasticity,even botox, cures spasticity.

Ask your doctor about side effects.

Abrupt discontinuation of intrathecal baclofen, regardless of the cause, has resulted in sequelae that include high fever, altered mental status, exaggerated rebound spasticity, and muscle rigidity, that in rare cases has advanced to rhabdomyolysis, multiple organ-system failure and death.

The most common adverse reactions in patients with spasticity of spinal origin were somnolence, dizziness, nausea, hypotension, headache, convulsions and hypotonia. The most common adverse reactions in patients with spasticity of cerebral origin were agitation, constipation, somnolence, leukocytosis, chills, urinary retention and hypotonia.

Because there is no decent understanding of spasticity or any known cures there is the hope/placebo that the drugs given will help.

See the original article:

What's the Reason for Stroke Spasticity Drugs?

in

Deans' Stroke Musing

Sunday Stroke Survival: Spasticity Revisited

Jo Murphey
The Murphey Saga

Sunday, February 14, 2016

Well, I went to the orthopedist again for a follow-up on my shoulder. The good news is that he is no longer strongly suggesting surgery to fix my shoulder. The bad news, dropping the other shoe, is that he said, "It's as good as it's gonna get post stroke and with the spasticity."

I wanted to scream back at him that I needed my right shoulder almost fully functional like it was prior to this event. But I didn't. I bit my tongue because he was partially right.

The spasticity is a major player in my life right now. It mimics a frozen shoulder and arm on bad days. But at least now I can say "on bad days" instead of constantly. That a huge improvement. Unfortunately, my office visit was a couple of days past a tumble for me. I can always count on being more spastic after a fall. At least for a few days. Then my body will recover to it's dry needling success stance of minor spasticity.

Caregiver: Goodbye, Bobmobile

Diane
The Pink House On The Corner

Friday, February 12, 2016

Yesterday, I sold The Bobmobile.  I sold it back to the dealer whom we had bought it from, the same one who gave me the $30,000 offer on the phone. And they were true to that promise.

I also donated Bob's power chair.  I'd been wanting to do this, but not sure how to get it to the right type of person who needed that type of specialized wheelchair.  Turns out the company I sold the van to, also sells/repairs power chairs and has many contacts with local charities and often donates chairs to folks in need who cannot otherwise afford them.  The salesman told me that they would be happy to refurbish Bob's wheelchair and find it new home with the right person who otherwise couldn't afford it.  So, one of the employees drove me home (in the Bobmobile) and picked up Bob's wheelchair.

Goodbye!

It was bittersweet.

Sweet, because the 30G will pay off my Honda Fit, and then some.  And I've checked the power chair off my list of things to do...

Bitter, because every time I get rid of something that was Bob's, I feel like I'm erasing him....

In other news, today I'm expecting Sally, a long time friend from up north, who will be staying here for about a week, and I am looking forward to it, and especially looking forward to having company on Valentine's Day, which will be hard for me, because that day also marks our one year anniversary of moving into the new house.

See the original article:

Goodbye, Bobmobile

in

The Pink House On The Corner

Jester: Whatever Happened To...

Jackie Poff
Stroke Survivors Tattler

I always wondered what happened to Dennis the Menace when he got older...

TED Talks - Jocelyne Bloch: The Brain May be Able to Repair Itself -- With Help

TED.com

December 2015

Through treating everything from strokes to car accident traumas, neurosurgeon Jocelyne Bloch knows the brain's inability to repair itself all too well. But now, she suggests, she and her colleagues may have found the key to neural repair: Doublecortin-positive cells. Similar to stem cells, they are extremely adaptable and, when extracted from a brain, cultured and then re-injected in a lesioned area of the same brain, they can help repair and rebuild it. "With a little help," Bloch says, "the brain may be able to help itself."


Filmed December 2015 at TEDGlobal>Geneva