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Clinical Understanding of Spasticity: Implications for Practice

机译:痉挛的临床理解:对实践的启示

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摘要

Spasticity is a poorly understood phenomenon. The aim of this paper is to understand the effect of spasticity on daily life and identify bedside strategies that enhance patient's function and improve comfort. Spasticity and clonus result from an upper motor neuron lesion that disinhibits the tendon stretch reflex; however, they are differentiated in the fact that spasticity results in a velocity dependent tightness of muscle whereas clonus results in uncontrollable jerks of the muscle. Clinical strategies that address function and comfort are paramount. This is a secondary content analysis using a qualitative research design. Adults experiencing spasticity associated with neuromuscular disorder were asked to participate during inpatient acute rehabilitation. They were asked to complete a semistructured interview to explain and describe the nature of their experienced spasticity on daily basis. Spasticity affects activities of daily living, function, and mobility. Undertreated spasticity can lead to pain, immobility, and risk of falls. There were missed opportunities to adequately care for patients with spasticity. Bedside care strategies identified by patients with spasticity are outlined. Uses of alternative therapies in conjunction with medications are needed to better manage spasticity. Patient reports on spasticity are important and should be part of clinical evaluation and practice.
机译:痉挛是一个鲜为人知的现象。本文的目的是了解痉挛对日常生活的影响,并确定可增强患者功能并改善舒适度的床头策略。痉挛和阵挛由上运动神经元病变抑制肌腱伸展反射引起。然而,它们的区别在于,痉挛会导致肌肉的速度依赖性紧绷,而梭状肌会导致肌肉的无法控制的抽搐。解决功能和舒适性的临床策略至关重要。这是使用定性研究设计进行的次要内容分析。经历与神经肌肉疾病有关的痉挛的成年人被要求参加住院急诊康复期间。他们被要求完成一个半结构化访谈,以解释和描述他们每天经历的痉挛的性质。痉挛会影响日常生活,功能和活动能力。痉挛不充分可能导致疼痛,行动不便和跌倒的风险。错过了充分照顾痉挛患者的机会。概述了痉挛患者确定的床头护理策略。为了更好地控制痉挛,需要结合药物使用替代疗法。病人的痉挛报告很重要,应该成为临床评估和实践的一部分。

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