Spasticity: principles of orthopaedic management of upper and lower limb spasticity secondary to stroke

Q4 Medicine

Orthopaedics and Trauma Pub Date : 2026-08-01 Epub Date: 2026-07-09 DOI:10.1016/j.mporth.2026.05.009

Rebecca Lewis, Sameera Abas, Catriona Heaver, Simon Hill, Simon Pickard

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引用次数: 0

Abstract

Stroke (cerebrovascular accident) is an extremely common disease with an estimated incidence of 100,000 per year in the UK. Up to 30% of patients will develop spasticity following stroke, the sequelae of which can have a significant impact on patients' abilities to carry out activities of daily living (ADLs), leading to a significant reduction in function and independence levels. Abnormal limb posture as a consequence of an upper motor neurone lesion affects patients' ability to ambulate and carry out simple hygiene; increases the risk of pressure sores, and can have a lasting impact on patients’ self-perception and image. In the upper limb there are multiple patterns of deformity whereas in the lower limb the predominant pattern is an equinovarus position of the foot and ankle. This article summarizes the principles of orthopaedic assessment and treatment for both upper and lower limb spasticity in stroke patients with a review of contemporary orthopaedic literature. Many of the principles described are also relevant to spasticity secondary to other upper motor neurone pathologies.

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痉挛：中风继发的上肢和下肢痉挛的骨科治疗原则

中风（脑血管意外）是一种极其常见的疾病，估计在英国每年有10万人发病。高达30%的患者在中风后会出现痉挛，其后遗症会对患者进行日常生活活动（ADLs）的能力产生重大影响，导致功能和独立性水平显著降低。由于上运动神经元病变导致的肢体姿势异常影响患者行走和简单卫生的能力；增加压疮的风险，并可能对患者的自我认知和形象产生持久的影响。上肢有多种类型的畸形，而下肢主要是足和踝关节的马蹄内翻。本文通过对当代骨科文献的回顾，总结了脑卒中患者上肢和下肢痉挛的骨科评估和治疗原则。所描述的许多原理也与其他上运动神经元病理继发的痉挛有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

1.00

自引率

0.00%

发文量

期刊介绍： Orthopaedics and Trauma presents a unique collection of International review articles summarizing the current state of knowledge and research in orthopaedics. Each issue focuses on a specific topic, discussed in depth in a mini-symposium; other articles cover the areas of basic science, medicine, children/adults, trauma, imaging and historical review. There is also an annotation, self-assessment questions and a second opinion section. In this way the entire postgraduate syllabus will be covered in a 4-year cycle.