ABSTRACT

Spasticity is a very important medical as well as social issue because it can greatly affect a person’s health, function, comfort, care delivery, and selfimage. Medical issues that can arise secondarily to spasticity include contractures, skin ulcers, pain, and even subluxation. Although the exact prevalence and incidence of spasticity in acquired brain injury (ABI) is not known, the prevalence of spasticity has been estimated to be approximately 500,000 to over 2 million in USA and 12 million in world.(1,2) Traumatic brain injury (TBI) in itself is very common in the USA with approximately 2 million episodes per year.(3)

Definition of spasticity

Because spasticity has been hard to characterize, there are several definitions seen in the literature.(4) Spasticity has been defined as follows:

A condition in which stretch reflexes that are normally latent become obvious. The tendon reflexes have a lowered threshold to tap, the response of the tapped muscle is increased, and usually muscles besides the tapped one respond; tonic stretch reflexes are affected in the same way.(5)

A motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one component of the upper motoneuron syndrome.(5)

A disorder of spinal proprioceptive reflexes, manifested clinically as tendon jerk hyperreflexia and an increase in muscle tone that becomes more apparent the more rapid the stretching movement.(6)

As we can see from these definitions, spasticity involves muscles that are

extraordinarily prone to contracting, especially when the muscle is trying to be stretched.