Treatment of Spasticity

Educational Need

It is estimated that more than 500,000 people in the United States and 12 million people worldwide have some degree of spasticity.1 Spasticity is a common complication of a number of neurologic maladies, including the following:2,3

• Spinal cord trauma

o 11,000 new cases/year

o 200,000 current survivors

• Multiple sclerosis

o 10,000 new cases/year

o 300,000-400,000 current survivors

• Cerebral palsy

o 5,000-10,000 new cases/year

o Approximately 700,000 current survivors

• Stroke

o 400,000-750,000 new cases/year

o 4.4 million current survivors

As indicated above, spasticity is a common result of stroke. Following a stroke, approximately 65% of patients develop spasticity.1 Each year approximately 700,000 people experience a new or recurrent stroke; accounting for approximately 1 out of 15 deaths in the United States. Although the incidence of stroke mortality has declined in the past 3 decades, the estimated number of noninstitutionalized stroke survivors increased from 1.5 million to 2.4 million between the early 1970s and the early 1990s.4-6 According to the Framingham Heart Study, at 6 months poststroke, 30% of stroke survivors were unable to walk without assistance and 26% were dependent on others for activities of daily living.7 The estimated direct and indirect cost for stroke in 2006 was $62.7 billion.4

Spasticity is a movement disorder, usually involving the muscles of the arms and legs, that is characterized by stiff or tight muscles that can interfere with voluntary muscle movements. Spasticity results from an interruption of the neuronal circuitry regulating the muscles—or how fast the joint is moved through its range. The most common definition for spasticity currently in use was first published in 1980: “a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon...