Hi David,
Sorry to hear about your stroke and the ongoing implications of spasticity on your quality of life and function. Just as the impact of stroke varies significantly from person to person, dependent on the location, type and a number of other factors, spasticity is similar. The degree of spasticity (mild, moderate, severe) and what muscles or limbs are involved can vary significantly. How one responds to therapy also varies. The focus tends to be on management rather than cure.
Exercise and botulinum toxin are two options, there is also lower grade evidence for electrical stimulation and EMG biofeedback. A number of the systematic reviews found botulinum toxin A reduced spasticity and global improvement was noted by the stroke survivor and care giver on goal attainment scales. The reviews found that effectiveness at an activity level is less clear and no change was found on Quality of Life (QOL).
We are currently reviewing our Clinical Guidelines so it will be interesting to see whether the evidence has changed. You can access the sections on spasticity management on page 99. The new guidelines will be released later in the year.
Are you receiving ongoing input from a physiotherapist, occupational therapist and rehab physician? A referral to a spasticty clinic may be beneficial to review all treatment options. Fatigue, stress and other factors can exacerbate spasticity so manaing those factors is also important.
I hope this helps. If you wish to discuss further please call StrokeLine on 1800 787 653.
Simone - Occupational Therapist