Shoulder joints, surrounding muscles and rotator cuffs
Elbows, biceps and forearm muscles
Hands, wrists and fingers/thumbs
Hip joints
Knees, including the thigh and calf muscles
Ankle joints
Yes, when it causes
Pain and stiffness
Contractures or joint dislocations
Skin breakdown
Problems with transfers, mobility and function
Poor positioning, spasms, difficulty in care, increased caregiver burden
Difficulty in reaching therapy goals and increasing strength
Pain may develop due to positioning or how the bones grow
Movement, function and motor skills lessen
Stuck joints or bone misalignments may appear over time
Skin breaks down
Caregiver burdens increase
Positioning and transfers become more difficult
Provide pain relief
Prevent worsening of contractures
Improve positioning, decrease skin breakdown
Increase tolerance of treatments such as orthoses / splinting and/or Neuromuscular Electrical Stimulation (NMES)
Maintain and improve strength
Avoid deformity in children as the child grows
Improve outcome of orthopedic procedures
Develop better function and gait
Reduce loss of abilities as the child grows
Improve care and hygiene, decrease caregiver burden
Many treatments are available depending on the goals for your child and family. The Spasticity Team at Texas Children’s works together to determine the best treatment plan. Treatments include therapies, splinting, medications and orthopedic and neurosurgery procedures.
Many children have both spasticity and dystonia present.
If only one type of high muscle tone is treated (removed or significantly reduced), then the other may be more obvious. The remaining type of hypertonia can negatively affect joint function in the future as well.
Knowing exactly the cause of high muscle tone can be important in tailoring therapies to the individual patient.
Some medications can be helpful for dystonia but not spasticity.
A surgery called selective dorsal rhizotomy improves spasticity but will not change dystonia.
In orthopedic surgeries such as tendon transfers, some outcomes are less predictable if dystonia is present.
