Gait Rehabilitation in Patients with Calf Muscle Spasticity

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Spasticity is one of the major complaints of patients with spinal cord injuries. It has negative effects such as limitations in activities of daily living (ADLs), pain, fatigue, sleep disorders, instability, joint contractures, pressure ulcers, and infection, and decreases gait ability through changes in timing of gait-related muscle contraction and co-contraction. Spasticity, also, is a major factor inhibiting functional recovery, as it reduces joint range of motion (ROM), joint contracture, and severe functional impairment of ADLs. Erik et al. emphasized that aggressive treatment of spasticity is required as patients with spasticity have a 1-year treatment cost more than 4 times higher than that of patients without spasticity, indicating that spasticity increases not only functional limitations but also increases the financial burden. Therefore, a multidisciplinary approach is being attempted to control spasticity in clinical settings.

Calf Muscle Spasticity

The treatments generally used for the relief of spasticity in patients with spinal cord injury include medical treatments, physical therapy, and surgical therapy; among them, medical treatment is the most common. However, prescribed anti-spastic medications have adverse effects such as sedation, drowsiness, insomnia, fatigue, muscle weakness, ataxia, dizziness, hypotension, and depression, reduction of memory and attention, hallucination, and toxicity-induced hepatic damage, which may negatively affect the quality of life of patients with spinal cord injury.


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