There is considerable debate on the definition, physiological nature and importance of spasticity. Although spasticity is less common than assumed in the past, it represents a considerable burden for those who develop it, affecting up to 40% of people with severe weakness after stroke, and is considered severe and disabling in about 15% of people. It is associated with pain, contracture and other motor impairments (Wissel et al, 2013; Zorowitz et al, 2013; Glaess-Leistner et al, 2021). [2023]
Any joint that does not move frequently is at risk of developing shortening of surrounding tissues leading to restricted movement. This is referred to as a contracture, and is not uncommon in limbs affected by spasticity. Contractures can impede activities such as washing or dressing, and may also be uncomfortable or painful and limit the ability to sit in a wheelchair or mobilise. Splinting is the process of applying a prolonged stretch through an external device, most commonly splints or serial casts, historically believed to prevent or treat contractures. Standardised measures for ease of care and resistance to passive stretches include the Arm Activity measure and modified Ashworth Scale respectively. [2023]