Diagnosis of spasticity is mainly based on clinical evaluation that should include:
- Clinical history
- Physical examination
- evaluation of stretch reflexes (e.g., deep tendon reflexes, involuntary muscle contractions provoked by stretching the muscle with a tap on the tendon that connects the muscle to a bone)
- passive and active motion
- Function, e.g., toileting, eating, sleeping, dressing, sitting, standing, and walking
A proper assessment of the individual’s clinical and neurological status is critical in developing an effective treatment plan with achievable goals.
Spasticity is diagnosed if the patient shows an increased resistance to passive movements that increases with speed and typical positioning of the limbs, due to increased muscle tone. The diagnosis is not complicated for rehabilitation specialists but unfortunately a lot of other specialists/HCP are not trained and thus don’t recognized the symptoms or when they do so, don’t see the potential benefit of an adapted treatment.
The features of spasticity should be assessed individually for each patient, with the focus on three main areas: The clinical pattern of motor function, the patient’s ability to control his or her muscles, and how muscle stiffness and any contractures worsen the functional problems. The clinical pattern is of particular interest as it helps to identify the muscles affected by spasticity and thus to determine an appropriate treatment. Some physicians use diagnostic nerve blocks (local transient anesthesia of nerve(s)) to evaluate the involvement of muscles in a specific spastic pattern), or electromyography (EMG, evaluating activity of muscles while the patient performs a movement or a task via external electrodes).