Spasticity and Tone Management Clinic & Outpatient Therapy Services
Spasticity and Tone Management Clinic
Tone abnormalities often cause significant pain and discomfort for patients with chronic disabilities. Simple issues such as personal hygiene, dressing, and proper bed and chair positioning can become serious problems. Spasticity and dystonia can also lead to balance problems, joint deformities, and difficulties tolerating splints or braces.
Our Spasticity Management Services at the Braintree Hospital Rehabilitation are committed to improving the quality of life for patients with chronic spasticity or dystonia. Through a coordinated effort and close communication with patient caregivers, we strive to increase functional abilities and independence, and simplify patient care at home or in extended care facilities.
Team Members
The Spasticity and Mobility Management Team at Braintree Rehabilitation Hospital has assembled several disciplines, all with extensive experience in the practical application of rehabilitation techniques and interventions for spasticity. The selection of the proper treatment for each individual is essential to assure good functional outcomes and patient satisfaction. Through this team effort, input from all aspects of rehabilitation are considered and the most beneficial. Yet practical treatments are recommended.
Rehabilitation Physiatry: A Physiatrist with fellowship training in the care of chronic neurological disease and a variety of neuromedical treatment options for the abnormal tone and spasticity, such as blocks, baclofen pumps, oral medication, and therapies. Our Medical Director is Stephen F. Koelbel, MD
Physical Therapy: With an emphasis put on the lower extremity, as well as bracing expertise, this senior clinician will provide physical options for management of tone, including therapeutic exercise, casting, and bracing. She is also capable of implementing home based exercise regimens to maintain gains made in direct therapies when appropriate.
Occupational Therapy: This clinician brings extensive experience in the rehabilitation of the arm and hand, with particular emphasis on painful hemiplegic shoulders, wrist, and finger positioning, and restoration of upper extremity control. The Occupational Therapist is also able to offer a program of exercise, casting, splinting, and adaptive equipment to enhance function and reduce pain.
Orthotist: Our Orthotics service works in close concert with other members of the team to adjust, revise, or design new braces and foot plates as indicated by the individual's need.
Neurosurgery / Anesthesiology / Orthopedic Surgery: The surgeons communicate well with the referring staff in our spasticity clinic. These physicians are capable of installing the pumps, performing tendon lengthening, and other orthopedic procedures, and of controlling pain at reasonable levels.
Rehabilitation Nursing: These professionals are able to provide the feedback to the rest of the program staff as to how their interventions have changed the individuals' ability to function. They also work with individuals on bladder training and assist in the out patient management of the baclofen pump refills.
Our Goals at the Spasticity Clinic are to Identify:
- What aspects of tone and spasticity stand to benefit from treatment
- What functional gains are likely to occur as a result of treatment
- What surgical treatment may be most useful and appropriate
- The time frame necessary to experience functional improvement
- The most cost effective but durable management options possible
- What ancillary service(s) will maximize functional gains once tone is reduced and the technical goal is achieved
Appropriate Patients Include Those With:
- Cerebral Vascular Accident
- Traumatic Brain Injury
- Multiple Sclerosis
- Spinal Cord Injury
- Parkinson's Disease
- Cerebral Palsy
- Encephalitis
- Huntington's Disease
Treatment Recommendations May Include:
- Oral Medications
- Botox® - Botulinum Toxin Injection
- Phenol Nerve Injections
- Intrathecal Baclofen Pumps (ITB™)
- Bioness® H200 & L300
- Surgical Tendon Lengthening / Serial Casting
- Bracing / Splinting
- Wheelchair Seating Clinic
- Physical &/or Occupational Therapy
You may call our Spasticity Clinic at Braintree Rehabilitation Hospital directly at: (781) 348-2202
South Shore
Braintree
Spasticity and Tone Management Outpatient Therapy
Spasticity and other disorders of motor control commonly accompany the long-term effects of stroke, traumatic brain injury, multiple sclerosis, and a host of other neurological disorders. The development of spasticity occurs as motor recovery occurs following neurological injury. It is well recognized that spasticity can either enhance or interfere with function. It may be useful for standing ability but interfere with one's ability to get in and out of bed. Often spasticity and other disorders of tone such as rigidity and tremor create secondary musculoskeletal problems, such as shoulder impingement syndrome or "bursitis." Muscles of the trunk, pelvis, and bladder can also be affected by spasticity and create new problems in addition to the ones caused by spasticity in the limbs.
Even when spasticity allows standing or transfer ability, it may simultaneously interfere with other functional activities, including interrupting sleep, creating chronic pain syndromes, impairing balance and adding to the metabolic and cardiovascular demands of exercise. Our Physical and Occupational Therapists will work closely with your referring Specialty or Primary Care Physician to ensure your best outcome.
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