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Breakthroughs in the spasticity management: Are non-pharmacological treatments the future?

The present paper aims at providing an objective narrative review of the existing non-pharmacological treatments for spasticity. Whereas pharmacologic and conventional physiotherapy approaches result well effective in managing spasticity due to stroke, multiple sclerosis, traumatic brain injury, cerebral palsy and incomplete spinal cord injury, the real usefulness of the non-pharmacological ones is still debated. We performed a narrative literature review of the contribution of non-pharmacological treatments to spasticity management, focusing on the role of non-invasive neurostimulation protocols (NINM). Spasticity therapeutic options available to the physicians include various pharmacological and non-pharmacological approaches (including NINM and vibration therapy), aimed at achieving functional goals for patients and their caregivers. A successful treatment of spasticity depends on a clear comprehension of the underlying pathophysiology, the natural history, and the impact on patient's performances. Even though further studies aimed at validating non-pharmacological treatments for spasticity should be fostered, there is growing evidence supporting the usefulness of non-pharmacologic approaches in significantly helping conventional treatments (physiotherapy and drugs) to reduce spasticity and improving patient's quality of life. Hence, non-pharmacological treatments should be considered as a crucial part of an effective management of spasticity.
- University of Messina Italy
- Centro Neurolesi Bonino Pulejo Italy
- University of Messina Italy
- Università degli studi di Salerno Italy
Multiple Sclerosis, Cerebral Palsy, Disease Management, Electric Stimulation Therapy, Vibration, High-Energy Shock Waves, Stroke, Treatment Outcome, Muscle Spasticity, Multiple sclerosis; Repetitive transcranial magnetic stimulation; Spinal cord injury; Stroke; Transcranial direct current stimulation; Cerebral Palsy; Electric Stimulation Therapy; Forecasting; High-Energy Shock Waves; Humans; Multiple Sclerosis; Muscle Spasticity; Spinal Cord Injuries; Stroke; Treatment Outcome; Vibration; Disease Management; Quality of Life, Quality of Life, Humans, Repetitive transcranial magnetic stimulation; Transcranial direct current stimulation; Stroke; Multiple sclerosis; Spinal cord injury, Spinal Cord Injuries, Forecasting
Multiple Sclerosis, Cerebral Palsy, Disease Management, Electric Stimulation Therapy, Vibration, High-Energy Shock Waves, Stroke, Treatment Outcome, Muscle Spasticity, Multiple sclerosis; Repetitive transcranial magnetic stimulation; Spinal cord injury; Stroke; Transcranial direct current stimulation; Cerebral Palsy; Electric Stimulation Therapy; Forecasting; High-Energy Shock Waves; Humans; Multiple Sclerosis; Muscle Spasticity; Spinal Cord Injuries; Stroke; Treatment Outcome; Vibration; Disease Management; Quality of Life, Quality of Life, Humans, Repetitive transcranial magnetic stimulation; Transcranial direct current stimulation; Stroke; Multiple sclerosis; Spinal cord injury, Spinal Cord Injuries, Forecasting
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).69 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 1% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
