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Spasticity
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== History == Historical progression of spasticity and the upper motor neuron lesion on which it is based has progressed considerably in recent decades. However, the term "spasticity" is still often used interchangeably with "upper motor neuron syndrome" in the clinical settings, and it is not unusual to see patients labeled as "spastic" who actually demonstrate not just spasticity alone, but also an array of upper motor neuron findings.<ref name="pmid15448572">{{cite journal | vauthors = Ivanhoe CB, Reistetter TA | title = Spasticity: the misunderstood part of the upper motor neuron syndrome | journal = American Journal of Physical Medicine & Rehabilitation | volume = 83 | issue = 10 Suppl | pages = S3βS9 | date = October 2004 | pmid = 15448572 | doi = 10.1097/01.PHM.0000141125.28611.3E | s2cid = 45445777 }}</ref> Research has clearly shown that exercise is beneficial for spastic muscles,<ref>{{cite journal | vauthors = Ada L, Dorsch S, Canning CG | title = Strengthening interventions increase strength and improve activity after stroke: a systematic review | journal = The Australian Journal of Physiotherapy | volume = 52 | issue = 4 | pages = 241β248 | year = 2006 | pmid = 17132118 | doi = 10.1016/s0004-9514(06)70003-4 | doi-access = free }}</ref> even though in the very early days of research it was assumed that strength exercise would ''increase'' spasticity. Also, from at least the 1950s through at least the 1980s, there was a strong focus on other interventions for spastic muscles, particularly stretching and [[orthotics|splinting]], but the evidence does not support these as effective.<ref name="pmid18534551">{{cite journal | vauthors = Bovend'Eerdt TJ, Newman M, Barker K, Dawes H, Minelli C, Wade DT | title = The effects of stretching in spasticity: a systematic review | journal = Archives of Physical Medicine and Rehabilitation | volume = 89 | issue = 7 | pages = 1395β1406 | date = July 2008 | pmid = 18534551 | doi = 10.1016/j.apmr.2008.02.015 }}</ref> While splinting is not considered effective for decreasing spasticity, a range of different orthotics are effectively used for preventing [[muscle contracture]]s on patients with spasticity. In the case of [[spastic diplegia]] there is also a permanent [[neurosurgical]] treatment for spasticity, [[selective dorsal rhizotomy]], that directly targets nerves in the spine that cause the spasticity, and destroys them, so that the spasticity cannot be activated at all.{{citation needed|date=December 2020}}
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