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Spasticity Management

Spasticity is a condition which most commonly presents as muscle tightness, joint stiffness and spasms. Spasticity is caused by the disruption of the nerves which bring about muscle contraction and therefore joint movement. If left untreated spasticity can lead to:

  • Muscle pain
  • Reduced range of movements at joints (such as the ankle)
  • Muscle tightness
  • Decreased coordination
  • Loss of selective muscle control
  • Decreased speed of movement
  • Decreased strength
  • Decreased endurance
  • Joint stiffness

Conditions associated with spasticity include:

  • Cerebral palsy
  • Spina bifida
  • Brain injury
  • Spinal cord injury
  • Congenital abnormalities
  • Muscular dystrophy
  • Idiopathic toe walking
  • Peripheral neuropathy
  • Brachial plexus
  • Arthrogryposis
  • Syndactyly

This is not an extensive list of conditions. If you are unsure if your child would be suitable for a drop foot splint, please contact us to discuss.

At Children’s Orthotics, we have a wide range of orthotics that can assist in treating spasticity including:

Gaiters

Gaiters are fabric orthoses that wrap around the arms or legs. Gaiters have metal inserts to improve strength of the gaiter and prevent it from bending. They can be fitted to a child’s arms or legs to keep the affected limb in a straight position. They are often worn for periods of the day or at night time to provide a prolonged muscle stretch.

Benefits

  • Simple but effective
  • Restricted movement of a limb in a certain direction
  • Reduction of muscle pain and discomfort
  • Used in conjunction with botox injections to maximise muscle stretch

Resting Splints (Upper limb)

Resting splints are orthotic devices designed to be worn over the hand and wrist when resting or sleeping. They come in various materials such as fabric or thermoplastic and can be bought off the shelf or custom moulded to fit your child’s hand. Muscle contraction is a common effect of spasticity, over time this can cause the muscle to shorten. The resting splints hold the hand in an extended position (opposite to a closed fist position) to reduce contractures in the hand and help manage pain.

Benefits

  • Can be worn when sleeping or resting
  • Custom built or bought off the shelf
  • Effective in managing pain
  • Easy to maintain and manage
  • Can be used in conjunction with botox injections

Dynamic Stretching Devices (Upper and lower limbs)

A dynamic tension splint works by using a tension spring that is integrated into the brace, this is usually done via a mechanical hinge. The spring enables a mild, long duration stress on the affected joint to facilitate tissue remodelling. The tension within the spring can be adjusted to suit the needs of the user, this is usually guided by pain level or the range of motion goals set..

Benefits

  • Adjustable spring to increase or reduce stretch
  • Pain reduction
  • Increased joint range of motion
  • Can be used in conjunction with botox injections

Serial Casts

Serial casting is a procedure aimed at providing children with an increased range of movement. This procedure uses a fibreglass cast with padding inside to hold a part of the body in a position that will stretch the tight muscle. A new cast is applied weekly and will stay on for 2 - 6 weeks.. Subsequent casts are made to progressively stretch the joint and increase the range of motion until the desired range of movement is achieved. Children are given plaster shoes to wear over the top of the casts so they can still walk and function surprisingly well despite the restriction of the cast.

Benefits

  • Most efficient way to increase joint range of movement
  • Corrects joint alignment so that the appropriate orthotic devices can be provided
  • Prevents future surgery (such as Achilles lengthening)
  • Helps prevent deformity
  • Decrease pain and assist with ease of care for activities of daily living
  • Can be used in conjunction with botox injections

AFO (Ankle Foot Orthoses)

An AFO provides support specifically to the joints of the foot and ankle. Rigid and hinged AFOs are often prescribed to limit unwanted movements at the ankle that may lead to spasticity and muscle tightness. Over time the muscles around the ankle joint can be held in a stretched position to help improve the range of movement.

Benefits

  • Improved alignment
  • Increased support and stability
  • Can help promote natural walking patterns
  • Available in a wide range of models to suit specific needs
  • Can be used in conjunction with botox injections
  • Can have a range of patterns and styles

It is worth noting that other orthotic devices are available in assisting with spasticity management. If you have any questions, please contact our team of experienced paediatric orthotists for more advice.

To get in touch or arrange an appointment, you can call us at 0330 088 3949 or email office@orthotics.co.uk.

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