Neurological rehabilitation and the management of spasticity

Abstract

Neurorehabilitation is often thought of as a stand-alone process occurring in a defined unit. However, patients with neurological conditions make up a large proportion of general medical admissions and general practitioner consultations. They often present with an upper motor neurone syndrome that requires careful management of their weakness, disordered motor control, spasticity and bladder/bowel dysfunction. Spasticity management can be particularly challenging, but is rewarding if physical and pharmacological measures are used appropriately and in a timely manner. This review attempts to explain the process of rehabilitation and how it can improve the care of neurological patients in all settings. Through the basic principles of rehabilitation – assessment, goal-setting, intervention and evaluation – function can be optimized while preventing complications and minimizing distress to patients, families and carers.