Page 23 - Mobility Management, February 2018
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                                  Addressing Spasticity in the Seating Evaluation
 Since spasticity can be present with so many mobility- related diagnoses — and because clinic assessment time is so limited and valuable — it can be helpful
to have a “go-to” checklist when discussing
spasticity with clients and caregivers. This list is provided by Cynthia Petito, OTR/L, ATP, CAPS.
10 Questions to Ask During a Seating Assessment
1. What is the cause of spasticity?
2. How long has the spasticity been present?
3. Has the spasticity worsened over time?
4. What treatments have been tried and what were the
outcomes of treatment?
5. Has the spasticity caused muscle and tendon shortening?
6. What type of contractors have developed due to prolonged spasticity, i.e., muscle or bone
contractures or both?
7. Is there a plan for more invasive treatment,
such as Botox or tendon releases?
8. Does the patient have the cognition to carry
over the motor planning and muscle re-education if treatment is indicated?
9. Has the patient learned to use the spastic motor patterns to carry out functional tasks in their daily life?
10. If spastic movements are blocked or inhibited, does this create barriers to motor coordination and motor control of other muscle groups that may be functional? Or does inhibition improve motor planning of other muscle groups? m
References (via Lee Ann Hoffman)
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Ansari N.N., Naghdi S., Arab T.K., Jalaie S. (2008). “The inter- rater and interrater reliability of the Modi ed Ashworth Scale
in the assessment of muscle spasticity: limb and muscle group effect.” Neurorehabilitation. 23 (3): 231–7.
Ashworth B. (1964) Preliminary trial of carisoprodol in multiple sclerosis. Practitioner (192) 540-2.
Bolhasani H, Ansari N.N, Naghdi S, (2012) Comparing the validity of the Modi ed Modi ed Ashworth Scale (MMAS) and the Modi ed Tardieu Scale (MTS) in the assessment of wrist  exor spasticity in patients with stroke: protocol for a neuro- physiological study. BMJ Open (2) e001394. doi: 10.1136/ bmjopen-2012-001394.
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Lance J.W (1980) Symposium synopsis. In Feldman RG, fckLRYoung RR, Koella WP (eds). Spasticity: Disordered Motor Control. Chicago, IL: Year Book (485-94).
Lange M.L. (2009) Sleep positioning. Positioning isn’t just for wheelchairs anymore. http://occupational-therapy.advancedweb. com/article/sleep-positioning.aspx,25,3:34.
Mendoza S.M., Gōmez-Conesa A., Montesinos M.D.H. (2015) Association between gross motor function and postural control in
sitting in children with cerebral palsy: a correlation study in Spain. BMC Pediatrics (15) 1-7.
National Collaborating Centre for woman’s and children’s health (UK). (2002) Spasticity in Children and young people with non-progressive Brain Disorders: Management of Spasticity and Co-Existing Motor Disorders and their early musculoskeletal complications. London. RCOG Press; Jul. (NICE Clinical Guidelines, No.145.) 4, Physical and/or occupational therapy).
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Pope P. (2007b) Night Time Positioning for People with Multiple Sclerosis. News from MS Trust, (11) Part 4. ISSN 1466-559X.
Porter D., Michael S., & Kirkwood C. (2007). Patterns of postural deformity in non-ambulant people with cerebral palsy: what is the relationship between the direction of scoliosis, direction of pelvic obliquity, direction of windswept hip deformity and side of hip dislocation? Clinical Rehabilitation, 21(12), 1087–1096.
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