Stroke is a condition that occurs when the blood supply to the brain is cut off due to blockage or rupture of a blood vessel. Symptoms that may occur due to stroke, such as:
- Your speech becomes unclear or slurred, you may even not be able to speak at all
- The eyes and mouth look down on one side of the face
- Reduced hand and leg strength
- Stiff (spastic) hands
The recovery period for stroke patients is very important, especially to prevent disabilities or deficiencies that may arise after a stroke. However, it takes quite a long time to recover to its original state. Therefore, one thing that can be done is physiotherapy. This aims to ensure that neurological function can return to normal or minimize possible defects that may occur. The length of physical recovery is relative, this depends on each person. Physiotherapy can last several months or even years. Usually therapy will be stopped if the patient's condition no longer shows progress.
This discussion is about spasticity in the hands, which is one of the consequences of stroke. In spasticity, the muscles feel tense, making it difficult for the muscles to move. This disrupts activities. For example, spasticity in the biceps muscle puts the elbow in a bent position, making it difficult for the patient to straighten the elbow to pick up items or shake hands. Spasticity generally appears within a few months after a stroke. Find out more information about spasticity through the review below.
What is meant by Spasticity?
Spasticity is a condition where the muscles contract continuously without realizing it, so that the muscles are stiff, tensed , have resistance when moved , and are not flexible.
During a stroke, the arms, legs or even the face will become paralyzed.
Often, post-stroke spasticity makes sufferers feel like they are moving very slowly or like they are carrying a heavy load on their muscles.
In fact, muscles will feel sore when they are resting or when moved. Of course, this condition will make the sufferer uncomfortable. If you pay attention, it appears that the muscles are in an unusual position or are actually bent when resting.
How common is this condition?
The American Stroke Association states that around 25-43% of stroke patients will experience spasticity in the first year after stroke. Not all stroke patients will experience spasticity.
Post-stroke spasticity occurs more often in young stroke sufferers caused by bleeding. This condition appeared several months after the attack.
Problems due to Spasticity:
- Difficulty dressing: with spastic elbows in a bent position (flexed) patients generally have difficulty wearing trousers or clothes.
- Difficulty taking care of yourself: for example when bathing, washing/combing your hair, or eating alone, because it is difficult to straighten your elbows.
- Difficulty picking up/holding things
Causes of spasticity
In a stroke, the area of the brain that controls (brakes) muscle contractions is damaged, so that there is no inhibition (brake) for muscle contractions. As a result, the muscles contract continuously.
Spasticity does not only occur in strokes. Brain injuries due to accidents, cervical spine injuries, cerebral palsy, brain tumors and multiple sclerosis are other causes of spasticity.
Management of spasticity
Spasticity must be treated in a multidisciplinary manner. No one therapeutic modality is superior to another.
- Physical and occupational therapy
This therapy must be undertaken by all stroke patients, with or without spasticity.
Usually, therapists will recommend regular exercises to stretch and strengthen your muscles.
The therapist may recommend using a cast or brace to help stretch tight muscles after a stroke.
Meanwhile, electrical stimulation may also be needed, especially if you experience contractures.
- Medicines and botulinum toxin injections
Several medications will be recommended by the doctor to reduce the symptoms of spasticity.
Botulinum toxin injections can also be used to relax spastic muscles . This toxin is injected into spastic muscles. Botulinum toxin injections are quite effective in reducing spasticity. However, this toxin must be injected repeatedly (every 4-6 months).
- Operation
There are several procedures that can be performed for patients with poststroke spasticity. These procedures aim to: 1. Reduce spasticity itself, 2. Stretch joints that have contractures, 3. Stabilize bones/joints that are deformed due to spasticity and contractures.
Surgery on spastic hands is carried out no sooner than 1 year after a stroke, because in the first year there is still improvement that can occur. Surgery generally provides results that can be maintained in the long term.
Article written by dr. Margareta Arianni, Sp.OT (K) Hand Surgery (Specialist in Orthopedics & Traumatology, Consultant Hand Surgeon at EMC Alam Sutera Hospital).