Spastic Cerebral Palsy

The most prevalent type of cerebral paralysis is spastic cerebral paralysis. The muscles of persons with spastic cerebral paralysis can look robust and jerky.

Spasticity is a hypertonic type of elevated tone of the muscle. This leads to rigid muscles that make it difficult or impossible to move.

● Muscles appear rigid because muscle messages are wrongly transmitted to the brain via the damaged area

● When spasticity affects the muscle, the faster the limb is moved, the harder it looks

● Damage to the corticospinal and corticobulbar tracts of the brain and spinal cord caused spasticity.

● Spasticity is observed in several disorders, including cerebral paralysis, traumatic brain damage, backbone injury, stroke, and multiple sclerosis

● It may be difficult to move from one location to another and to control particular muscles or muscle groups that are needed for certain actions such as manipulating objects or talking.

Spasticity is caused by damage to the motor cortex of the brain, which can occur before, during, or after birth in people with cerebral palsy.
When it comes to cerebral palsy, spasticity can affect every muscle group in the body, but some typical patterns can be observed.

Effect on the upper extremities (arms and hands)

If one or both arms are affected by spasticity it could lead to:  
  • Bending on the elbow (the elbow is bent)
  • Bending on the wrist (the wrist is bent)
  • Flexion on your fingertips (the fingers are fisted)
  Spasticity in these locations might lead to problems with hands and arms tasks:
  • Get suited up
  • Toilet and wash yourself
  • Manipulation of objects by eating or drinking
It can also affect the capacity of a person to utilize his or her weapons for balance, which can lead to standing and walking problems.  

Effect on the lower limbs (legs)

When one or both legs are affected by spasticity, the following can occur:
  • Flexion of the hip (which causes the leg to lift upwards when lying or the body to lean forwards in standing)
  • Thigh adduction, or scissoring’ (which causes the legs to pull together)
  • Knee flexion (which alters a person’s standing posture)
  • Feet in the Equinovarus stance (tightness in the calf results from the pointing of toes inwards and downwards with the heel off the ground )
Spasticity is one or both legs’ muscles that can impair a person’s ability to walk.
  • Maintain an erect posture.
  • Maintain an erect posture.
  • Transfer to a new position
  • Reposition yourself in bed
  • Run and walk

Effect on speech

Additionally, spasticity can occur in smaller muscles or muscle groups, such as the tongue, face muscles, or vocal folds. Spasticity in these locations might manifest itself in the following ways:  
  • Slow, inaccurate oral movements that require considerable effort (eating and drinking may also be affected)
  • Slurred speech sounds
  • A voice that sounds harsh or constricted
  This can affect a person’s capacity to communicate verbally and may necessitate the use of alternate modes of communication (such as drawings, symbols, or voice generating equipment).
While the brain injury that results in spasticity does not vary over time, the repercussions of spasticity on the body can. Spasticity’s long-term effects: ▪ Soft tissue alterations (muscles, tendons, and ligaments) that result in muscle stiffness, atrophy (muscle deterioration or wasting), and fibrosis (changes in the properties of the muscle fibers) ▪ Spasticity-affected muscles have difficulties extending out to keep up with bone growth, resulting in shorter-than-normal muscles. This stops a joint from obtaining its full range of motion normally and is referred to as contracture. ▪ Short, contract muscles can pull on the osteoarthritis, causing bone anomalies, such as spine scoliosis and hip dislocation. ▪ Pain – chronic spastic muscular overactivity might result in muscle pain. Additionally, pain can occur as a result of changes in joint position and abnormalities caused by the spastic muscle’s aberrant pull.
A thorough assessment is critical for evaluating the presence, severity, and effect of spasticity. Additionally, it is critical for assessing an individual’s reaction to a spasticity control technique. When a physician evaluates spasticity, he or she will consider
  • Which muscles are spastic
  • Spasticity severity in each of the afflicted muscles
  • How an individual’s muscles can be controlled (can they activate individual muscles, can they voluntarily control their muscles to perform functional tasks)
  • Any spasticity-related secondary effects (such as contracture) that impair the individual’s ability to conduct functional duties.
Additionally, a clinician will finish
  1. A clinical examination that entails ‘hands-on’ sensation for stiffness when moving a limb, joint range of motion and strength measurements, and
  2. A functional assessment in which the individual is observed performing daily activities in a natural setting, with or without the assistance of equipment or other aids (eg bathing, dressing, sitting, walking, climbing stairs)