Management Hypertonia

1 management

1.1 physical interventions
1.2 pharmaceutical interventions
1.3 nutritional interventions

management

therapeutic interventions best individualized particular patients.

basic principles of treatment hypertonia avoid noxious stimuli , provide frequent range of motion exercise.

physical interventions

physiotherapy has been shown effective in controlling hypertonia through use of stretching aimed reduce motor neuron excitability. aim of physical therapy session inhibit excessive tone far possible, give patient sensation of normal position , movement, , facilitate normal movement patterns. while static stretch has been classical means increase range of motion, pnf stretching has been used in many clinical settings reduce muscle spasticity.

icing , other topical anesthetics may decrease reflexive activity short period of time in order facilitate motor function. inhibitory pressure (applying firm pressure on muscle tendon) , promoting body heat retention , rhythmic rotation (slow repeated rotation of affected body part stimulate relaxation) have been proposed potential methods decrease hypertonia. aside static stretch casting, splinting techniques extremely valuable extend joint range of motion lost hypertonicity. more unconventional method limiting tone deploy quick repeated passive movements involved joint in cyclical fashion; has been demonstrated show results on persons without physical disabilities. more permanent state of improvement, exercise , patient education imperative. isokinetic, aerobic, , strength training exercises should performed prescribed physiotherapist, , stressful situations may cause increased tone should minimized or avoided.

pharmaceutical interventions

baclofen, diazepam , dantrolene remain 3 commonly used pharmacologic agents in treatment of spastic hypertonia. baclofen drug of choice spinal cord types of spasticity, while sodium dantrolene agent acts directly on muscle tissue. tizanidine available. phenytoin chlorpromazine may potentially useful if sedation not limit use. ketazolam, not yet available in united states, may significant addition pharmacologic armamentarium. intrathecal administration of antispastic medications allows high concentrations of drug near site of action, limits side effects.

nutritional interventions

recent research indicates biomolecule taurine may effective hypertonia, perhaps through benzodiazepine-like modulation of inhibitory neurotransmitter gaba or neuromuscular effects of increasing intracellular calcium levels.