Matthews Dennis J, Balaban Birol
Department of Physical Therapy and Rehabilitation, Medicine Faculty of Colorado Denver University, Aurora, Colorado 80045, USA.
Acta Orthop Traumatol Turc. 2009 Mar-Apr;43(2):81-6. doi: 10.3944/AOTT.2009.081.
Management of spasticity is a major challenge to the rehabilitation team. The initial management has centered on the elimination of externally exacerbating causes, physical therapy, splinting and casting. Medical management has centered on anti-spasticity medication use, but more recently focal treatment methods including phenol blocks and botulinum toxin have been utilized. There has been an increased use of intrathecal baclofen in the management of refractory tone. Dorsal rhizotomy has been advocated for a selective population of children with spasticity. There is no standardized approach to spasticity management and this paper will discuss the importance of evidence-based treatment of spasticity that is adapted for the individual child.
痉挛的管理是康复团队面临的一项重大挑战。初始管理主要集中在消除外部加重因素、物理治疗、夹板固定和石膏固定。药物治疗主要集中在使用抗痉挛药物,但最近也采用了包括苯酚阻滞和肉毒杆菌毒素在内的局部治疗方法。鞘内注射巴氯芬在难治性肌张力管理中的应用有所增加。对于特定的痉挛儿童群体,有人主张进行背根切断术。目前尚无痉挛管理的标准化方法,本文将讨论针对个体儿童进行基于证据的痉挛治疗的重要性。