Emerging Concepts and Evidence in Novel Approaches for Spasticity Management

Many neurological diseases commonly cause muscle spasticity. Several important related symptoms (muscle tone, sleep, bladder, pain) are mediated, optimization of spasticity treatment must balance the reduction of muscle spasticity and the related symptoms, as well as recover of motor function. Facilitation and modulation of neural plasticity through rehabilitative treatment as early interventions with repetitive goal-oriented intensive therapy, non-invasive brain stimulation, and pharmacological agents, are the keys to promote motor recovery. Appropriate treatment with botulinum toxin therapy and neurolysis with phenol or alcohol are examples of how to create a transient plastic state of the neuromotor system that allows motor re-learning and recovery in chronic stages. The precision of injections, dilution, dosages, the accurate evaluation of spasticity is needed. Neural mechanisms of spasticity do not fully explain the motor dysfunction and recover in patients with spastic disorders. Peripheral non-neural mechanisms are also not fully understood. These all facilitate updated evidence in spasticity management.



The goal of this Research Topic is to shed the light on recent advances of emerging theories and management in adult and children spasticity. The examples are hyaluronan hypothesis, dry needling, the hydro-dissection effect on spasticity, technology as non-invasive brain stimulation, peripheral magnetic or electrical stimulation, clinical and instrumental evaluations in spasticity, the precisions of injection, ergonomic during injection, dosage and dilution of botulinum toxin, phenol and alcohol, hyaluronidase, cryoneurotomy, orthosis, and assistive devices, even Practical Guidance for Outpatient Spasticity Management During the Coronavirus (COVID-19) Pandemic.