Skip to main content
SpringerLink
Log in

S2k-Leitlinie: Therapie des spastischen Syndroms

Eine fachgesellschaftsübergreifende Aktualisierung der Leitlinie der Deutschen Gesellschaft für Neurologie

S2k guideline: treatment for spasticity

Association of the Scientific Medical Societies in Germany update of the German Neurology Society guideline

  • Leitlinie
  • Published:
DGNeurologie Aims and scope

A Leserbriefe to this article was published on 13 December 2019

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Ada L, Canning CG, Low SL (2003) Stroke patients have selective muscle weakness in shortened range. Brain 126:724–731

    PubMed  Google Scholar 

  2. Alfiere V (1982) Electrical treatment of spasticity. Scand J Rehabil Med 14:179–182

    Google Scholar 

  3. Aloraini SM, Gaverth J, Yeung E, MacKay-Lyons M (2015) Assessment of spasticity after stroke using clinical measures: a systematic review. Disabil Rehabil 37:2313–2323

    PubMed  Google Scholar 

  4. Amatya B, Khan F, La ML, Demetrios M, Wade DT (2013) Non pharmacological interventions for spasticity in multiple sclerosis. Cochrane Database Syst Rev (2):CD009974. https://doi.org/10.1002/14651858.CD009974.pub2

  5. Ashford S, Slade M, Turner-Stokes L (2013) Initial psychometric evaluation of the Arm Activity Measure (ArmA): a measure of activity in the hemiparetic arm. Clin Rehabil 27:728–740

    PubMed  Google Scholar 

  6. Ashford S, Turner-Stokes L (2013) Systematic review of upper-limb function measurement methods in botulinum toxin intervention for focal spasticity. Physiother Res Int 18:178–189

    PubMed  Google Scholar 

  7. Ashworth B (1964) Preliminary trial of carisoprodol in multiple sclerosis. Practitioner 192:540–542

    CAS  PubMed  Google Scholar 

  8. Azouvi P, Mane M, Thiebaut JB et al (1996) Intrathecal baclofen administration for control of severe spinal spasticity: functional improvement and long-term follow-up. Arch Phys Med Rehabil 77:35–39

    CAS  PubMed  Google Scholar 

  9. Baker JA, Pereira G (2015) The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: a systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach. Clin Rehabil 29:731–740

    PubMed  Google Scholar 

  10. Baker JA, Pereira G (2016) The efficacy of Botulinum Toxin A for limb spasticity on improving activity restriction and quality of life: a systematic review and meta-analysis using the GRADE approach. Clin Rehabil 30:549–558

    PubMed  Google Scholar 

  11. Barker RN, Brauer SG, Carson RG (2008) Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel nonrobotic device. A randomized clinical trial. Stroke 39:1800–1807

    PubMed  Google Scholar 

  12. Bass B, Weinshenker B, Rice GP et al (1988) Tizanidine versus baclofen in the treatment of spasticity in patients with multiple sclerosis. Can J Neurol Sci 15:15–19

    CAS  PubMed  Google Scholar 

  13. Beaulieu LD, Schneider C (2013) Effects of repetitive peripheral magnetic stimulation on normal or impaired motor control. A review. Neurophysiol Clin 43:251–260

    CAS  PubMed  Google Scholar 

  14. Bes A, Eyssette M, Pierrot-Deseilligny E, Rohmer F, Warter JM (1988) A multi-centre, double-blind trial of tizanidine, a new antispastic agent, in spasticity associated with hemiplegia. Curr Med Res Opin 10:709–718

    CAS  PubMed  Google Scholar 

  15. Bhakta BB, Cozens JA, Chamberlain MA, Bamford JM (2000) Impact of Botulinum Toxin type A on disability and carer burden due to arm spasticity after stroke: a randomised double blind placebo controlled trial. J Neurol Neurosurg Psychiatr 69:217–221

    CAS  Google Scholar 

  16. Bohannon RW, Smith MB (1987) Interrater reliability of a modified Ashworth Scale of muscle spasticity. Phys Ther 67:206–207

    CAS  PubMed  Google Scholar 

  17. Borrini L, Bensmail D, Thiebaut JB, Hugeron C, Rech C, Jourdan C (2014) Occurrence of adverse events in long-term intrathecal baclofen infusion: a 1-year follow-up study of 158 adults. Arch Phys Med Rehabil 95(6):1032–1038

    PubMed  Google Scholar 

  18. Boster AL, Bennett SE, Bilsky GS et al (2016) Best practices for intrathecal Baclofen therapy: screening test. Neuromodulation 19:616–622

    PubMed  Google Scholar 

  19. Brashear A, Gordon MF, Elovic E, Kassicieh D, Marciniak C, Do M, Lee CH, Jenkins S, Turkel C (2002a ) Intramuscular injection of Botulinum Toxin for the treatment of wrist and finger spasticity after stroke. N Engl J Med 347(6):395–400

    CAS  PubMed  Google Scholar 

  20. Brashear A, Zafonte R, Corcoran M, Galvez-Jimenez N, Gracies JM, Gordon MF, McAfee A, Ruffing K, Thompson B, Williams M, Lee CH, Turkel C (2002b ) Inter- and intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upperlimb poststroke spasticity. Arch Phys Med Rehabil 83:1349–1354

    PubMed  Google Scholar 

  21. Cai Y, Zhang CS, Liu S et al (2017) Electroacupuncture for poststroke spasticity: a systematic review and meta-analysis. Arch Phys Med Rehabil 98:2578–2589

    PubMed  Google Scholar 

  22. Carda S, Invernizzi M, Baricich A, Cisari C (2011) Casting, taping or stretching after Botulinum Toxin type A for spastic equinus foot: a single-blind randomized trial on adult stroke patients. Clin Rehabil 25(12):1119–1127

    PubMed  Google Scholar 

  23. Chambers HG (1997) The surgical treatment of spasticity. Muscle Nerve Suppl 6:S121–S128

    CAS  PubMed  Google Scholar 

  24. Chen SC, Chen YL, Chen CJ, Lai CH, Chiang WH, Chen WL (2005) Effects of surface electrical stimulation on the muscle-tendon junction of spastic gastrocnemius in stroke Patients. Disabil Rehabil 27(3):105–110

    PubMed  Google Scholar 

  25. Chen JC, Liang CC, Shaw FZ (2005) Facilitation of sensory and motor recovery by thermal intervention for the hemiplegic upper limb in acute stroke patients. A single-blind randomized clinical trial. Stroke 36:2665–2669

    PubMed  Google Scholar 

  26. Corston RN, Johnson F, Godwin-Austen RB (1981) The assessment of drug treatment of spastic gait. J Neurol Neurosurg Psychiatry 44:1035–1039

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Chou R, Peterson K, Helfand M (2004) Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review. J Pain Symptom Manage 28:140–175

    CAS  PubMed  Google Scholar 

  28. Creamer M, Cloud G, Kossmehl P, Yochelson M, Francisco GE, Ward AB, Wissel J, Zampolini M, Abouihia A, Berthuy N, Calabrese A, Loven M, Saltuari L (2018) Intrathecal Baclofen therapy versus conventional medical management for severe poststroke spasticity: results from a multicentre, randomised, controlled, open-label trial (SISTERS). J Neurol Neurosurg Psychiatry 89:642–650

    PubMed  Google Scholar 

  29. Cutter NC, Scott DD, Johnson JC et al (2000) Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial. Arch Phys Med Rehabil 81:164–169

    CAS  PubMed  Google Scholar 

  30. Demetrios M, Khan F, Turner-Stokes L, Brand C, McSweeney S (2013) Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity. Cochrane Database Syst Rev 6:CD9689

  31. Dettmers C, Teske U, Hamzei F, Uswatte G, Taub E, Weiller C (2005) Distributed form of constraint-induced movement therapy improves functional outcome and quality of life after stroke. Arch Phys Med Rehabil 86:2004–2009

    Google Scholar 

  32. Dietz V, Sinkjaer T (2007) Spastic movement disorder: impaired reflex function and altered muscle mechanics. Lancet Neurol 6:725–733

    PubMed  Google Scholar 

  33. Dietz V, Young RR (2003) The syndrome of spastic paresis. In: Brandt T, Caplan LR, Dichgans J, Diener HC, Kennard C (Hrsg) Neurological disorders: course and treatment. Academic Press, Amsterdam, S 1247–1257

    Google Scholar 

  34. Dressler D, Bhidayasiri R, Bohlega S et al (2017) Botulinum Toxin therapy for treatment of spasticity in multiple sclerosis: review and recommendations of the IAB-Interdisciplinary Working Group for Movement Disorders task force. J Neurol 264:112–120

    CAS  PubMed  Google Scholar 

  35. Duncan GW, Shahani BT, Young RR (1976) An evaluation of baclofen treatment for certain symptoms in patients with spinal cord lesions. Neurology 24:441–446

    Google Scholar 

  36. Duncan PW, Lai SM, Bode RK, Perera S, DeRosa J (2003) Stroke Impact Scale-16: A brief assessment of physical function. Neurology 60:291–296

    CAS  PubMed  Google Scholar 

  37. Dymarek R, Ptaszkowski K, Slupska L, Halski T, Taradaj J, Rosinczuk J (2016) Effects of extracorporeal shock wave on upper and lower limb spasticity in post-stroke patients: a narrative review. Top Stroke Rehabil 23:293–303

    PubMed  Google Scholar 

  38. Ertzgaard P, Ward AB, Wissel J, Borg J (2011) Practical considerations for goal attainment scaling during rehabilitation following acquired brain injury. J Rehabil Med 43:8–14

    PubMed  Google Scholar 

  39. Fabbri M, Leodori G, Fernandes RM et al (2016) Neutralizing antibody and Botulinum Toxin therapy: a systematic review and meta-analysis. Neurotox Res 29:105–117

    CAS  PubMed  Google Scholar 

  40. Fernandez-Tenorio E, Serrano-Munoz D, Avendano-Coy J, Gomez-Soriano J (2016) Transcutaneous electrical nerve stimulation for spasticity: A systematic review. Neurologia S0213–4853(16):30111–30116. https://doi.org/10.1016/j.nrl.2016.06.009

    Google Scholar 

  41. Finnerup NB (2017) Neuropathic pain and spasticity: intricate consequences of spinal cord injury. Spinal Cord 12:1046–1050

    Google Scholar 

  42. Fukuhara T, Kamata I (2004) Selective posterior rhizotomy for painful spasticity in the lower limbs of hemiplegic patients after stroke: report of two cases. Neurosurgery 54:1268–1272

    PubMed  Google Scholar 

  43. Giovannelli M, Borriello G, Castri P et al (2007) Early physiotherapy after injection of botulinum toxin increases the beneficial effects on spasticity in patients with multiple sclerosis. Clin Rehabil 21:331–337

    CAS  PubMed  Google Scholar 

  44. Gracies JM, Marosszeky JE, Renton R et al (2000) Short-term effects of dynamic lycra splints on upper limb in hemiplegic patients. Arch Phys Med Rehabil 81:1547–1555

    CAS  PubMed  Google Scholar 

  45. Gracies JM, Brashear A, Jech R, McAllister P, Banach M, Valkovic P, Walker H, Marciniak C, Deltombe T, Skoromets A, Khatkova S, Edgley S, Gul F, Catus F, De Fer BB, Vilain C, Picaut P, International AbobotulinumtoxinA Adult Upper Limb Spasticity Study Group (2015) Safety and efficacy of AbobotulinumtoxinA for hemiparesis in adults with upper limb spasticity after stroke or traumatic brain injury: a double-blind randomised controlled trial. Lancet Neurol 14:992–1001

    CAS  PubMed  Google Scholar 

  46. Gracies JM, Esquenazi A, Brashear A, Banach M, Kocer S, Jech R, Khatkova S, Benetin J, Vecchio M, McAllister P, Ilkowski J, Ochudlo S, Catus F, Grandoulier AS, Vilain C, Picaut P, International AbobotulinumtoxinA Adult Lower Limb Spasticity Study Group (2017) Efficacy and safety of AbobotulinumtoxinA in spastic lower limb: randomized trial and extension. Neurology 89:2245–2253

    CAS  PubMed  PubMed Central  Google Scholar 

  47. GRADE working group (2004) Grading quality of evidence and strength of recommendations. BMJ 328:1490–1497

    PubMed Central  Google Scholar 

  48. Grigoriu AI, Dinomais M, Remy-Neris O, Brochard S (2015) Impact of injection-guiding techniques on the effectiveness of Botulinum Toxin for the treatment of focal spasticity and dystonia: a systematic review. Arch Phys Med Rehabil 96:2067–2078

    PubMed  Google Scholar 

  49. Harvey LA, Katalinic OM, Herbert RD, Moseley AM, Lannin NA, Schurr K (2017) Stretch for the treatment and prevention of contractures. Cochrane Database Syst Rev 1:CD007455. https://doi.org/10.1002/14651858.CD007455.pub3

  50. Hesse S, Bertelt C, Jahnke MT, Schaffrin A, Baake P, Malezic M, Mauritz KH (1995) Treadmill training with partial body weight support compared with physiotherapy in nonambulatory hemiparetic patients. Stroke 26:976–981

    CAS  PubMed  Google Scholar 

  51. Hesse S, Werner C, Pohl M, Mehrholz J, Puzich U, Krebs HI (2008a ) Mechanical armtrainer for the treatment of the severely affected arm after stroke: a single blinded randomized trial in two centers. Am J Phys Med Rehabil 87:779–788

    CAS  PubMed  Google Scholar 

  52. Hesse S, Kuhlmann H, Wilk J, Tomelleri C, Kirker SGB (2008b ) A new electromechanical trainer for sensorimotor rehabilitation of paralysed fingers: a case series in acute and chronic stroke patients. J Neuroeng Rehabil 5:21

    PubMed  PubMed Central  Google Scholar 

  53. Hesse S, Mach H, Fröhlich G, Behrend S, Werner C, Melzer I (2012) An early Botulinum Toxin A treatment in subacute stroke patients may prevent a disabling finger flexor stiffness six months later: a randomized controlled trial. Clin Rehabil 26(3):237–245

    CAS  PubMed  Google Scholar 

  54. Huang M, Liao LR, Pang MY (2017) Effects of whole body vibration on muscle spasticity for people with central nervous system disorders: a systematic review. Clin Rehabil 31:23–33

    PubMed  Google Scholar 

  55. Husemann B, Muller F, Krewer C, Heller S, Koenig E (2007) Effects of locomotion training with assistance of a robot-driven gait orthosis in hemiparetic patients after stroke. A randomized controlled pilot study. Stroke 38:349–354

    PubMed  Google Scholar 

  56. Hyman N, Barnes M, Bhakta B et al (2000) Botulinum Toxin (Dysport) treatment of hip adductor spasticity in multiple sclerosis: a prospective, randomised, double blind, placebo controlled, dose ranging study. J Neurol Neurosurg Psychiatry 68:707–712

    CAS  PubMed  PubMed Central  Google Scholar 

  57. Intiso D, Santamato A, Di RF (2017) Effect of electrical stimulation as an adjunct to Botulinum Toxin type A in the treatment of adult spasticity: a systematic review. Disabil Rehabil 39:2123–2133

    PubMed  Google Scholar 

  58. Iwata M, Kondo I, Sato Y et al (2003) An ankle-foot orthosis with inhibitor bar: effect on hemiplegic gait. Arch Phys Med Rehabil 84:924–927

    PubMed  Google Scholar 

  59. Kaji R, Osako Y, Suyama K et al (2010) Botulinum Toxin type A in post-stroke lower limb spasticity: a multicenter, doubleblind, placebo-controlled trial. J Neurol 257:1330–1337

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Kanovsky P, Slawek J, Denes Z, Platz T, Sassin I, Comes G, Grafe S (2009) Efficacy and safety of Botulinum Neurotoxin NT 201 in poststroke upper limb spasticity. Clin Neuropharmacol 32:259–265

    CAS  PubMed  Google Scholar 

  61. Kanovsky P, Slawek J, Denes Z, Platz T, Comes G, Grafe S, Pulte I (2011) Efficacy and safety of treatment with Incobotulinum Toxin A in post-stroke upper limb spasticity. J Rehabil Med 43:486–492

    PubMed  Google Scholar 

  62. Karadag-Saygi E, Cubukcu-Aydoseli K, Kablan N et al (2010) The role of kinesiotaping combined with Botulinum Toxin to reduce plantar flexors spasticity after stroke. Top Stroke Rehabil 17:318–322

    PubMed  Google Scholar 

  63. Katrak PH, Cole AMD, Poulos CJ, Mc Cauley JCK (1992) Objective assessment of spasticity, strength and function with early exhibition of dantrolene sodium after cerebrovascular accident: a randomised double-blind controlled study. Arch Phys Med Rehabil 73:4–9

    CAS  PubMed  Google Scholar 

  64. Khan F, Amatya B (2017a ) Rehabilitation in multiple sclerosis: a systematic review of systematic reviews. Arch Phys Med Rehabil 98:353–367

    PubMed  Google Scholar 

  65. Khan F, Amatya B, Bensmail D, Yelnik A (2017b ) Non-pharmacological interventions for spasticity in adults: an overview of systematic reviews. Ann Phys Rehabil Med S1877–0657(17):30415–30413. https://doi.org/10.1016/j.rehab.2017.10.001

    Google Scholar 

  66. Klebe S, Stevanin G, Depienne C (2015) Clinical and genetic heterogeneity in hereditary spastic paraplegias: from SPG1 to SPG72 and still counting. Rev Neurol (paris) 171(6–7):505–530

    CAS  Google Scholar 

  67. Kollen BJ, Lennnon S, Lyons B, Wheatley-Smith L, Scheper M, Buurke JH, Halfens J, Geurts ACH, Kwakkel G (2009) The effectiveness of the Bobath Concept in stroke rehabilitation. What is the evidence? Stroke 40:e89–e79

    PubMed  Google Scholar 

  68. Koog YH, Jin SS, Yoon K et al (2010) Interventions for hemiplegic shoulder pain: systematic review of randomised controlled trials. Disabil Rehabil 32:282–291

    PubMed  Google Scholar 

  69. Korzhova J, Sinitsyn D, Chervyakov A et al (2016) Transcranial and spinal cord magnetic stimulation in treatment of spasticity. A literature review and meta-analysis. Eur J Phys Rehabil Med 54:75–84

    PubMed  Google Scholar 

  70. Krach LE, Nettleton A, Klempka B (2006) Satisfaction of individuals treated long-term with continuous infusion of intrathecal baclofen by implanted programmable pump. Pediatr Rehabil 9:210–218

    CAS  PubMed  Google Scholar 

  71. van Kujik AA, Geurts ACH, Beevaart BJW, van Limbeek J (2002) Treatment of upper extremity spasticity in stroke patients by focal neuronal or neuromuscular blockade: a systematic review of the literature. J Rehabil Med 34:51–61

    Google Scholar 

  72. Kumru H, Benito-Penalva J, Valls-Sole J, Murillo N, Tormos JM, Flores C, Vidal J (2016) Placebo-controlled study of rTMS combined with Lokomat® gait training for treatment in subjects with motor incomplete spinal cord injury. Exp Brain Res 234:3447–3455

    CAS  PubMed  Google Scholar 

  73. Lakhan SE, Rowland M (2009) Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review. Bmc Neurol 9:59

    PubMed  PubMed Central  Google Scholar 

  74. Lance J (1908) Symposium synopsis. In: Feldman RG, Young RR, Koella WP (Hrsg) Spasticity: disordered motor control. Year Book Medical, Chicago, S 485–494

    Google Scholar 

  75. Lanin NA, Herbert RD (2003) Is hand splinting effective for adults following stroke? A systematic review and methodological critique of published research. Clin Rehabil 17:807–816

    Google Scholar 

  76. Lanin NA, Cusick A, McCluskey A, Herbert RD (2007a ) Effects of splinting on wrist contracture after stroke: a randomized controlled trial. Stroke 38:111–116

    Google Scholar 

  77. Lannin NA, Novak I, Cusick A (2007b ) A systematic review of upper extremity casting for children and adults with central nervous system motor disorders. Clin Rehabil 21:963–976

    CAS  PubMed  Google Scholar 

  78. Lapierre Y, Bouchard S, Tansey C et al (1987) Treatment of spasticity with tizanidine in multiple sclerosis. Can J Neurol Sci 14:513–517

    CAS  PubMed  Google Scholar 

  79. Lindsay C, Kouzouna A, Simcox C, Pandyan AD (2016) Pharmacological interventions other than botulinum toxin for spasticity after stroke. Cochrane Database Syst Rev 10:CD10362

  80. Lim JY, Koh JH, Paik NJ (2008) Intramuscular Botulinum Toxin-A reduces hemiplegic shoulder pain: a randomized, double-blind, comparative study versus intraarticular triamcinolone acetonide. Stroke 39(1):126–131 (Epub 2007 Nov 29)

    CAS  PubMed  Google Scholar 

  81. Manganotti P, Amelio E (2005) Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke. Stroke 36:1967–1971

    CAS  PubMed  Google Scholar 

  82. Martin A, Abogunrin S, Kurth H, Dinet J (2014) Epidemiological, humanistic, and economic burden of illness of lower limb spasticity in adults: a systematic review. Neuropsychiatr Dis Treat 10:111–122

    PubMed  PubMed Central  Google Scholar 

  83. Masiero S, Celia A, Rosati G, Armani M (2007) Robotic-assisted rehabilitation of the upper limb after acute stroke. Arch Phys Med Rehabil 88:142–149

    PubMed  Google Scholar 

  84. McIntyre A, Mays R, Mehta S et al (2014) Examining the effectiveness of intrathecal Baclofen on spasticity in individuals with chronic spinal cord injury: a systematic review. J Spinal Cord Med 37:11–18

    PubMed  PubMed Central  Google Scholar 

  85. Medaer R, Hellebuyk H, Van Den Brande E et al (1991) Treatment of spasticity due to stroke. A double-blind, cross-over trial comparing baclofen with placebo. Acta Ther 17:323–331

    Google Scholar 

  86. Meythaler JM, Guin-Renfroe S, Johnson A, Brunner RM (2001) Prospective assessment of tizanidine for spasticity due to acquired brain injury. Arch Phys Med Rehabil 82:1155–1163

    CAS  PubMed  Google Scholar 

  87. Michielsen ME, Selles RW, vd Geest JN, Eckhardt M, Yavuzer G, Stam HJ, Smits M, Ribbers GM, Bussmann JBJ (2011) Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: a phase II randomized controlled trial. Neurorehabil Neural Repair 25:223–233

    PubMed  Google Scholar 

  88. Miller LE, Zimmermann AK, Herbert WG (2016) Clinical effectiveness and safety of powered exoskeleton-assisted walking in patients with spinal cord injury: systematic review with meta-analysis. Med Devices (auckl) 9:455–466

    Google Scholar 

  89. Mills PB, Finlayson H, Sudol M, O’Connor R (2016) Systematic review of adjunct therapies to improve outcomes following botulinum toxin injection for treatment of limb spasticity. Clin Rehabil 30(6):537–548

    PubMed  Google Scholar 

  90. Mills PB, Dossa F (2016) Transcutaneous electrical nerve stimulation for management of limb spasticity: a systematic review. Am J Phys Med Rehabil 95:309–318

    PubMed  Google Scholar 

  91. Momosaki R, Yamada N, Ota E, Abo M (2017) Repetitive peripheral magnetic stimulation for activities of daily living and functional ability in people after stroke. Cochrane Database Syst Rev 6:CD11968

  92. Montané E, Vallano A, Laporte JR (2004) Oral antispastic drugs in nonprogressive neurologic diseases: a systematic review. Neurology 63:1357–1363

    PubMed  Google Scholar 

  93. Motta F, Buonaguro V, Stignani C (2007) The use of intrathecal Baclofen pump implants in children and adolenscents: safety and complications in 200 consecutive cases. J Neurosurg 107(Suppl 1):32–35

    PubMed  Google Scholar 

  94. Muche-Borowski C, Selbmann HK, Müller W et al (2012) Das AWMF-Regelwerk Leitlinien. http://www.awmf.org/leitlinien/awmf-regelwerk . Zugegriffen: 27. Aug. 2017 (1. Aufl.)

    Google Scholar 

  95. Nardone R, Langthaler PB, Orioli A, Höller P, Höller Y, Frey VN, Brigo F, Trinka E (2017) Effects of intermittent theta burst stimulation on spasticity after spinal cord injury. Restor Neurol Neurosci 35:287–294

    PubMed  Google Scholar 

  96. Naumann M, Jankovic J (2004) Safety of Botulinum Toxin type A: a systematic review and meta-analysis. Curr Med Res Opin 20:981–990

    CAS  PubMed  Google Scholar 

  97. Noth J (1991) Trends in the pathophysiology and pharmacotherapy of spasticity. J Neurol 238:131–139

    CAS  PubMed  Google Scholar 

  98. Ochs G (2004) In: Ochs G (Hrsg) Die Behandlung der schweren Spastizität. Thieme, Stuttgart

    Google Scholar 

  99. O’Dwyer NJ, Ada L, Neilson PD (1996) Spasticity and muscle contracture following stroke. Brain 119:1737–1749

    PubMed  Google Scholar 

  100. Olvey EL, Armstrong EP, Grizzle AJ (2010) Contemporary pharmacologic treatments for spasticity of the upper limb after stroke: a systematic review. Clin Ther 32:2282–2303

    CAS  PubMed  Google Scholar 

  101. Pandyan AD, Granat MH, Stott DJ (1997) Effects of electrical stimulation on flexion contractures in the hemiplegic wrist. Clin Rehabil 11:123–130

    CAS  PubMed  Google Scholar 

  102. Pandyan AD, Gregoric M, Barnes MP, Wood D, Van Wijck F, Burridge J, Hermens H, Johnson GR (2005) Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil 27:2–6

    CAS  PubMed  Google Scholar 

  103. Pinder RM, Brogden RN, Speight TM, Avery GS (1977) Dantrolene Sodium: a review of its pharmacological properties and therapeutic efficacy in spasticity. Drugs 13(1):3–23

    CAS  PubMed  Google Scholar 

  104. Pittock SJ, Moore AP, Hrdiman O et al (2003) A double-blind randomised placebo-controlled evaluation of three doses of Botulinum Toxin type A in the treatment of spastic equinovarus deformity after stroke. Cerebrovasc Dis 15:289–230

    CAS  PubMed  Google Scholar 

  105. Pizzi A, Carlucci G, Falsini C et al (2005a ) Evaluation of upper-limb spasticity after stroke: a clinical and neurophysiologic study. Arch Phys Med Rehabil 86:410–415

    PubMed  Google Scholar 

  106. Pizzi A, Carlucci G, Falsini C, Verdesca S, Grippo A (2005b ) Application of volar static splint in Poststroke spasticity of the upper limb. Arch Phys Med Rehabil 86:1855–1859

    PubMed  Google Scholar 

  107. Platz T, Eickhof C, van Kaick S, Engel U, Pinkowski C, Kalok S, Pause M (2005) Impairment-oriented training or Bobath therapy for arm paresis after stroke: a single blind, multi-centre randomized controlled trial. Clin Rehabil 19:714–724

    CAS  PubMed  Google Scholar 

  108. Platz T, Eickhof C, Nuyens G, Vuadens P (2005) Clinical scales for the assessment of spasticity, associated phenomena, and function: a systematic review of the literature. Disabil Rehabil 27:7–18

    CAS  PubMed  Google Scholar 

  109. Platz T, Vuadens P, Eickhof C, Arnold P, Van Kaick S, Heise K (2008) REPAS, a summary rating scale for resistance to passive movement: item selection, reliability and validity. Disabil Rehabil 30:44–53

    PubMed  Google Scholar 

  110. Platz T, van Kaick S, Mehrholz J, Leidner O, Eickhof C, Pohl M (2009) Best conventional therapy versus modular Impairment-Oriented Training (IOT) for arm paresis after stroke: a single blind, multi-centre randomized controlled trial. Neurorehabil Neural Repair 23:706–716

    PubMed  Google Scholar 

  111. Pak S, Patten C (2008) Strengthening to promote functional recovery poststroke: an evidence-based review. Top Stroke Rehabil 15:177–199

    PubMed  Google Scholar 

  112. Parke B, Penn RD, Savoy SM et al (1989) Functional outcome following delivery of intrathecal Baclofen. Arch Phys Med Rehabil 70:30–32

    CAS  PubMed  Google Scholar 

  113. Rosales RL, Kong KH, Goh KJ, Kumthornthip W, Mok VC, Delgado-De Los Santos MM, Chua KS, Abdullah SJ, Zakine B, Maisonobe P, Magis A, Wong KS (2012) Botulinum Toxin injection for hypertonicity of the upper extremity within 12 weeks after stroke: a randomized controlled trial. Neurorehabil Neural Repair 26:812–821

    PubMed  Google Scholar 

  114. Rosales RL, Efendy F, Teleg ES, Delos Santos MM, Rosales MC, Ostrea M, Tanglao MJ, Ng AR (2016) Botulinum Toxin as early intervention for spasticity after stroke or non-progressive brain lesion: a meta-analysis. J Neurol Sci 371:6–14

    CAS  PubMed  Google Scholar 

  115. Sadeghi M, Sawatzky B (2014) Effects of vibration on spasticity in individuals with spinal cord injury: a scoping systematic review. Am J Phys Med Rehabil 93:995–1007

    PubMed  Google Scholar 

  116. Safarpour Y, Mousavi T, Jabbari B (2017) Botulinum Toxin treatment in multiple sclerosis—a review. Curr Treat Options Neurol 19:33

    PubMed  Google Scholar 

  117. Saulino M, Anderson DJ, Doble J et al (2016) Best practices for intrathecal Baclofen therapy: troubleshooting. Neuromodulation 19:632–641

    PubMed  Google Scholar 

  118. Schramm A, Ndayisaba JP, Auf dem Brinke M, Hecht M, Herrmann C, Huber M, Lobsien E, Mehnert S, Reuter I, Stenner A, van der Ven C, Winterholler M, Kupsch A, Wissel J (2014) Spasticity treatment with Onabotulinumtoxin A: data from a prospective German real-life patient registry. J Neural Transm (vienna) 121:521–530

    CAS  Google Scholar 

  119. Simpson DM, Gracies JM, Graham HK, Miyasaki JM, Naumann M, Russmann B, Simpson LL, So Y (2008) Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence based review). Report of the therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Baillieres Clin Neurol 70:1691–1698

    CAS  Google Scholar 

  120. Simpson DM, Gracies JM, Yablon SA, Barbano R, Brashear A, BoNT/TZD Study Team (2009) Botulinum neurotoxin versus tizanidine in upper limb spasticity: a placebo-controlled study. J Neurol Neurosurg Psychiatry 80:380–385

    CAS  PubMed  Google Scholar 

  121. Simpson DM, Hallett M, Ashman EJ, Comella CL, Green MW, Gronseth GS, Armstrong MJ, Gloss D, Potrebic S, Jankovic J, Karp BP, Naumann M, So YT, Yablon SA (2016) Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 86:1818–1826

    CAS  PubMed  PubMed Central  Google Scholar 

  122. Sindou M, Mertens P (1988) Selective neurotomy of the tibial nerve for treatment of the spastic foot. Neurosurgery 23:738–744

    CAS  PubMed  Google Scholar 

  123. Smeulders M, Coester A, Kreulen M (2005) Surgical treatment for the thumb-in-palm deformity in patients with cerebral palsy. Cochrane Database Syst Rev 19(4):CD4093

  124. Specchio N, Carotenuto A, Trivisano M et al (2011) Prolonged episode of dystonia and dyskinesia resembling status epilepticus following acute intrathecal Baclofen withdrawal. Epilepsy Behav 21:321–323

    PubMed  Google Scholar 

  125. Stamenova P, Koytchev R, Kuhn K, Hansen C, Horvath F, Ramm S, Pongratz D (2005) A randomised, double-blind, placebo-controlled study of the efficacy and safety of tolperisone in spasticity following cerebral stroke. Eur J Neurol 12:453–461

    CAS  PubMed  Google Scholar 

  126. Stetkarova I, Yablon SA, Kofler M et al (2010) Procedure- and device-related complications of intrathecal baclofen administration for management of adult muscle hypertonia: a review. Neurorehabil Neural Repair 24:609–619

    PubMed  Google Scholar 

  127. Stien R, Nordal HJ, Oftedal SI et al (1987) The treatment of spasticity in multiple sclerosis: a double-blind clinical trial of a new antispastic drug tizanidine compared with Baclofen. Acta Neurol Scand 75:190–194

    CAS  PubMed  Google Scholar 

  128. Stoeckmann T (2001) Casting for the person with spasticity. Top Stroke Rehabil 8:27–35

    CAS  PubMed  Google Scholar 

  129. Takahashi CD, Der-Yeghiaian L, Le V, Motiwala RR, Cramer SC (2008) Robot-based hand motor therapy after stroke. Brain 131:425–437

    PubMed  Google Scholar 

  130. Taricco M, Pagliacci MC, Telaro E et al (2006) Pharmacological interventions for spasticity following spinal cord injury: results of a Cochrane systematic review. Eura Medicophys 42:5–15

    CAS  PubMed  Google Scholar 

  131. Thanikachalam V, Phadke CP, Ismail F, Boulias C (2017) Effect of Botulinum Toxin on Clonus: a systematic review. Arch Phys Med Rehabil 98:381–390

    PubMed  Google Scholar 

  132. Theriault ER, Huang V, Whiteneck G, Dijkers MP, Harel NY (2016) Antispasmodic medications may be associated with reduced recovery during inpatient rehabilitation after traumatic spinal cord injury. J Spinal Cord Med 14:1–9

    Google Scholar 

  133. Turkel CC, Bowen B, Liu J, Brin FM (2006) Pooled analysis of the safety of Botulinum Toxin type A in the treatment of poststroke spasticity. Arch Phys Med Rehabil 87:786–792

    PubMed  Google Scholar 

  134. Turner-Stokes L (2009) Goal Attainment Scaling (GAS) in rehabilitation: a practical guide. Clin Rehabil 23:362–370

    PubMed  Google Scholar 

  135. Tyson S, Connell L (2009) The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: a systematic review. Clin Rehabil 23:1018–1033

    PubMed  Google Scholar 

  136. Wade DT, Collin C, Stott C et al (2010) Meta-analysis of the efficacy and safety of Sativex (nabiximols), on spasticity in people with multiple sclerosis. Mult Scler 16:707–714

    CAS  PubMed  Google Scholar 

  137. Wang RY, Chan RC, Tsa MW (2000) Effects of thoraco-lumbar electric sensory stimulation on knee extensor spasticity of persons who survived Cerebrovascular Accident (CVA). J Rehabil Res Dev 37(1):73–80

    CAS  PubMed  Google Scholar 

  138. Ward A, Hayden S, Dexter M et al (2009) Continuous intrathecal Baclofen for children with spasticity and/or dystonia: goal attainment and complications associated with treatment. J Paediatr Child Health 45:720–726

    PubMed  Google Scholar 

  139. Wein T, Esquenazi A, Jost WH, Ward AB, Pan G, Dimitrova R (2018) OnabotulinumtoxinA for the treatment of poststroke distal lower limb spasticity: a randomized trial. Pm R 10:693–703

    PubMed  Google Scholar 

  140. Werner C, von Frankenberg S, Treig T, Konrad M, Hesse S (2002) Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients. Stroke 33:2895–2901

    CAS  PubMed  Google Scholar 

  141. Winter T, Wissel J (2013) Behandlung der Spastizität nach Schlaganfall. Konsultationsfassung der DGNR-Leitlinie. Neurol Rehabil 19:285–309

    Google Scholar 

  142. Wissel J, Muller J, Dressnandt J, Heinen F, Naumann M, Topka H, Poewe W (2000) Management of spasticity associated pain with Botulinum Toxin A. J Pain Symptom Manage 20:44–49

    CAS  PubMed  Google Scholar 

  143. Wissel J, Haydn T, Muller J, Brenneis C, Berger T, Poewe W, Schelosky LD (2006) Low dose treatment with the synthetic cannabinoid nabilone significantly reduces spasticity-related pain: a double-blind placebo-controlled cross-over trial. J Neurol 253:1337–1341

    CAS  PubMed  Google Scholar 

  144. Wissel J, Ward AB, Erztgaard P, Bensmail D, Hecht MJ, Lejeune TM, Schnider P, Altavista MC, Cavazza S, Deltombe T, Duarte E, Geurts AC, Gracies JM, Haboubi NH, Juan FJ, Kasch H, Katterer C, Kirazli Y, Manganotti P, Parman Y, Paternostro-Sluga T, Petropoulou K, Prempeh R, Rousseaux M, Slawek J, Tieranta N (2009) European consensus table on the use of Botulinum Toxin type A in adult spasticity. J Rehabil Med 41(1):13–25

    PubMed  Google Scholar 

  145. Wissel J, Manack A, Brainin M (2013) Toward an epidemiology of poststroke spasticity. Neurology 80(Suppl 2):S13–S19

    PubMed  Google Scholar 

  146. Wissel J, Verrier M, Simpson DM et al (2015) Post-stroke spasticity: predictors of early development and considerations for therapeutic intervention. Pm R 7:60–67

    PubMed  Google Scholar 

  147. Wissel J, Ganapathy V, Ward AB, Borg J, Ertzgaard P, Herrmann C, Haggstrom A, Sakel M, Ma J, Dimitrova R, Fulford-Smith A, Gillard P (2016) OnabotulinumtoxinA improves pain in patients with post-stroke spasticity: findings from a randomized, double-blind, placebo-controlled trial. J Pain Symptom Manage 52:17–26

    PubMed  Google Scholar 

  148. Wissel J, Bensmail D, Ferreira JJ, Molteni F, Satkunam L, Moraleda S, Rekand T, McGuire J, Scheschonka A, Flatau-Baqué B, Simon O, Rochford ET, Dressler D, Simpson DM, TOWER study investigators (2017) Safety and efficacy of IncobotulinumtoxinA doses up to 800 U in limb spasticity: The TOWER study. Neurology 88:1321–1328

    CAS  PubMed  PubMed Central  Google Scholar 

  149. Wu CL, Huang MH, Lee CL, Liu CW, Lin LJ, Chen CH (2006) Effect on spasticity after performance of dynamic-repeated-passive ankle joint motion exercise in chronic stroke patients. Kaohsiung J Med Sci 22:610–617

    PubMed  Google Scholar 

  150. Yadav V, Bever C Jr., Bowen J et al (2014) Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology. Neurology 82:1083–1092

    PubMed  PubMed Central  Google Scholar 

  151. Yan T, Hui-Chan CWY, Li LSW (2005) Functional electrical stimulation improves motor recovery of the lower extremity and walking ability of subjects with first acute stroke. A randomized placebo-controlled trial. Stroke 36:80–85

    PubMed  Google Scholar 

  152. Yavuzer G, Selles R, Sezer N, Sutbeyaz S, Bussmann JB, Koseoglu F, Atay MB, Stam HJ (2008) Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil 89:393–398

    PubMed  Google Scholar 

  153. Yelnik AP, Colle FM, Bonan IV et al (2007) Treatment of shoulder pain in spastic hemiplegia by reducing spasticity of the subscapular muscle: a randomized, double blind, placebo controlled study of Botulinum Toxin A. J Neurol Neurosurg Psychiatry 78:845–848

    PubMed  Google Scholar 

  154. Yun GJ, Chun MH, Park JY, Kim BR (2011) The synergic effects of mirror therapy and neuromuscular electrical stimulation for hand function in stroke patients. Ann Rehabil Med 35:316–321

    PubMed  PubMed Central  Google Scholar 

  155. Zdolsek HA, Olesch C, Antolovich G et al (2011) Intrathecal baclofen therapy: benefits and complications. J Intellect Dev Disabil 36:207–213

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Zentrum für NeuroRehabilitation, Beatmungs- und Intensivmedizin, Querschnittgelähmtenzentrum, An-Institut der Universität Greifswald, BDH-Klinik Greifswald gGmbH, Karl-Liebknecht-Ring 26a, 17491, Greifswald, Deutschland

    T. Platz

Authors
  1. T. Platz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Platz.

Ethics declarations

Interessenkonflikt

Die Originale der vollständig ausgefüllten Interessenerklärungen sind beim Leitlinienkoordinator/Editorial Office Leitlinien (EO) hinterlegt. In der Zusammenfassung werden nur die Angaben aufgeführt, für die ein thematisch relevanter Bezug zur Leitlinie festgestellt wurde. Die Ergebnisse der Bewertungen durch einen Interessenkonfliktbeauftragten der DGN und die umgesetzten Konsequenzen durch die Leitlinien-Gruppe sind angegeben. T. Platz (Koordinator): Vortrags- und Schulungstätigkeiten: DWI (Vortrag Exoskelett-Technologie; tws. LLBezug: Nutzung bei Querschnittgelähmten zur Mobilität) Krupp Kolleg Greifswald (Summer School Neurorehabilitation, tws. LL-Bezug, Thema Spastik inkludiert); Autoren/Koautorentätigkeit: u. a. Thieme, VG Wort zu Neurorehabilitation (tws. LL-Bezug, Thema Spastik inkludiert); Indirekte Interessen: DGNR, DSG, DGNKN, DMGP, BGNP, WFNR; Wissenschaftliche Tätigkeiten: Neurorehabilitation; Klinische Tätigkeiten: Neurologische Frührehabilitation, Querschnittgelähmtenbehandlung; Federführende Beteiligung: IOT-Kurse, Summer School Neurorehabilitation; Arbeitgeber: BDH-Klinik Greifswald | E. Donauer (Autor): Indirekte Interessen: DGNC, DGNR, BDNC; Arbeitgeber: MediClin Krankenhaus, Plau am See | L. Lehmler (Autor): Indirekte Interessen: BDH, Bundesverband Rehabilitation; Federführende Beteiligung: BDH-Klinik Vallendar, vormalig ltd. Berufspädagoge/Leiter der medizinischberuflichen Rehabilitation (Ausbildung); vormaliger Arbeitgeber (i. Ruhestand): BDH Bundesverband Rehabilitation | R. Tholen (Autor): Indirekte Interessen: Arbeitgeber: Physio Deutschland, Deutscher Verband für Physiotherapie (ZVK) | M. Vogel (Autor): Mitarbeit in einem wissenschaftlichen Beirat (Advisory Board): DMGP (Spastikbehandlung bei Querschnittlähmung); Indirekte Interessen: DMGP; Wissenschaftliche Tätigkeiten: Diverse mit Bezug zur Behandlung bei Rückenmarkläsionen; Klinische Tätigkeiten: Behandlung querschnittgelähmter Patienten; Arbeitgeber: Berufsgenossenschaftliche Unfallklinik Murnau | J. Wissel (Autor): Berater- bzw. Gutachtertätigkeit: Sintetica Pharma (Baclofen intrathekal), PMR Consult Gerätehersteller (Bewegungsanalyse, Messung von Spastik); Mitarbeit in einem wissenschaftlichen Beirat (Advisory Board): Allergan, Merz, Ipsen, Medtronic (jeweils zur Spastiktherapie); Vortrags- und Schulungstätigkeiten: Allergan, Merz, Ipsen, Medtronic, Sintetica (jeweils zur Spastiktherapie); Autoren/Koautorentätigkeit: Springer Verlag, Thieme Verlag (Lehrbücher zum Thema Spastik); Forschungsvorhaben/Durchführung klinischer Studien: Merz (BoNT bei Spastik), Medtronic (ITB bei Spastik), Ipsen (BoNT bei Spastik); Indirekte Interessen: Deutsche Dystonie Gesellschaft e.V., Therapienetzwerk Dystonie-Spastik Berlin-Brandenburg e. V.; Wissenschaftliche Tätigkeiten: Epidemiologie, Klinik und Behandlung der Spastizität und Dystonie; Klinische Tätigkeiten: Ambulante und stationäre Neurorehabilitation und Spastiktherapie; Federführende Beteiligung: Weiterbildungsinstitut des Arbeitskreises Botulinumtoxin der DGN e. V.; Arbeitgeber: Vivantes Netzwerk für Gesundheit GmbH, Krankenhaus Spandau.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

P. Berlit, Berlin

Redaktionskomitee der Leitlinie (beteiligte Organisationen)

Federführend (korrespondierender Autor): Prof. Dr. med. Thomas Platz, Greifswald (DGN), t.platz@bdh-klinik-greifswald.de

Prof. Dr. med. Jörg Wissel, Berlin (DGNR)

Prof. Dr. med. Erich Donauer, Plau (DGNC)

Dr. med. Matthias Vogel, Murnau (DMGP/Sektion Paraplegiologie der DGOU)

Reina Tholen, MPH, Köln (ZVK)

Lothar Lehmler (Patientenvertretung: BDH Bundesverband Rehabilitation e. V., Bonn)

Verbreitung und Implementierung

Die Leitlinie ist über das Portal der AWMF, www.awmf.org, sowie über die Website der Deutschen Gesellschaft für Neurologie (DGN) unter https://www.dgn.org/leitlinien/3777-ll-030-078-therapie-des-spastischen-syndroms-2019 frei zugänglich.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Platz, T. S2k-Leitlinie: Therapie des spastischen Syndroms. DGNeurologie 2, 258–279 (2019). https://doi.org/10.1007/s42451-019-0090-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42451-019-0090-2

Search

Navigation