Page 23 - Mobility Management, February 2018

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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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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