The Department of Physical Medicine and Rehabilitation at Montefiore
Patients with strokes, spinal cord disorders, multiple sclerosis, traumatic brain injuries and other neurological conditions are unable to reach their full potential of function and movement due to spasticity. In some, the tightness of muscles can be painful and interferes considerably with their activities of daily living. It can also cause pressure ulcers and seating and positioning issues.
We assess these patients from a functional standpoint to determine which treatment modality is suitable to the particular patient. Once this is determined, comprehensive spasticity management is offered.
Case by case decisions are made to treat patients with a variety of pharmaceutical agents. Specific muscle groups are targeted with neurolytic agents (botulinum toxin, phenol, alcohol). Nerve stimulators and EMG guidance are used for targeted delivery.
Stretching and positioning is maintained with physical and occupational therapies and appropriate bracing is done.
Intrathecal baclofen trials are done for selected patients and referrals for pump placements are made. Once pumps are placed the maintenance of the pump including refills and dosage adjustments are done.
Surgical referrals are made for tendon and muscle lengthening when necessary.