New ways to treat post-stroke spasticity are giving stroke patients, even those in vegetable state, new hope for recovery. The National Stroke Association (NSA) Website has already added Intrathecal Baclofen (ITB) Therapy and Botulinum toxin A (Botox) as part of its list on how to treat stroke patients with spasticity.
Spasticity is a resistance in the muscles to stretch after an injury to the central nervous system like stroke, which makes it difficult for patients to clench their hand, flex their fist, move their arm away from their body, or walk properly. Spasticity is often an underestimated effect of stroke which leads to grave pain for the patient if left untreated.
In the past, stroke patients who suffer spasticity are limited to oral medications that leave them sedated and with slow, limited developments despite physical therapy. Through ITB and Botox, post-stroke patients with spasticity can gain better recovery with no lethargy as medication is targeted to the specific area of the body needing therapy.
Relevant data reveal that patients with severe spasticity have shown an 89% reduction of spasticity-related pain on top of improving mobility, daily functioning and quality of life. Thus, ITB's dramatic effects to stroke patients has now pushed for a deeper investigation on its benefits through the Spasticity In STrokE Randomized Study (SISTERS), an international trial conducted in 20 European and US sites.
SISTERS aim to reduce spasticity after 6 months of treatment that is partnered with physical therapy (PT). Recently, European company Medtronic announced its enrollment of European patients into the study.
Any stroke patient with spasticity is candidate to ITB--from those who can walk and just want to walk better to those who are already in a vegetative state. What actually happens during therapy is that, a catheter is tunneled under the skin of the stroke patient where spasticity is experienced. This then is pushed up until it reaches the spine. Once there, a minimal amount of medication is pumped.
On the other hand, botox, such as the brand Dysport, has already been approved by the US Food and Drug Administration (FDA) to treat focal spasticity for stroke patients but intensive care is necessary in its application as it comes from the same bacterium that causes botulism. Botox aids recovery from spasticity because it blocks the the release of chemical messages that cause the muscles to contract, thereby ending spasms in the affected muscles. However, Botox therapy is repeated every three months which increases the price of stroke therapy.
These two new ways of treating spasticity are great breakthroughs especially since stroke patients with severe spasticity normally do not respond sufficiently to oral medication and physical therapy. Patients, on the other hand, can choose these treatments on top of medications they use together with it, like NeuroAid which is a price competitive alternative that helps shorten stroke rehabilitation on a longer term. Other ways to treat spasticity, according to NSA, are stretching, injections, and surgery.