Conditions We Treat
At Logan Health Children's Specialists, we care for babies, children, teens and young adults with developmental disabilities, illnesses and traumatic injuries. Knowing that collaboration and teamwork are necessary in the delivery of excellent care, the Logan Health Pediatric Rehabilitation Medicine team works closely with other specialists such as Neurology, Neurosurgery, Orthopedic Surgery and Genetics. Our mission is to provide comprehensive, family-centered rehabilitation services for a variety of diagnoses, including:
- Brachial Plexus Injury
- Brain and Spinal Cord Tumors
- Brain Injury (severe traumatic, concussion, stroke, and infection)
- Cancer-related problems
- Cerebral Palsy
- Chronic Pain
- Development Delay
- Debility or Deconditioning
- Lim Deficiencies
- Muscular Dystrophy
- Osteogenesis Imperfecta
- Other Neuromusclar Disorders
- Sensory Processing Dysfunction
- Spasticity (or other types of hypertonia, ex: Dystonia)
- Spina Bifida
- Spinal Cord Injury (traumatic, transverse myelitis, acute flaccid myelitis)
- Toe-walking and other Gait impairments
- Other services: Baclofen Pump Management, Botox Injections, Bracing Evaluation, EMG/Nerve Conduction Study Testing, and Specialized Equipment Evaluation.
What is Spasticity?
Spasticity is abnormal muscle tightness
due to an overactive spinal reflex. That same reflex that makes your leg jump when a doctor taps on your knee, is responsible for spasticity. This hyperactive reflex keeps muscles turned “on” causing muscle tightness and associated problems. This reflex becomes overactive (typically) due to a permanent injury to the brain or spinal cord
and can affect any muscle in the body. The type and location of the injury to the brain or spinal cord dictates which muscles are affect. For example, it could affect only a few muscles, one whole side of the body, or both sides of the body. It can even influence the way we talk, swallow food, poop and pee!
Did you know the highest risk of stroke is actually when we are babies and not as adults!
What problems can Spasticity cause?
Spasticity can lead to stiff or fixed joints call contractures
, interfere with the way we move or walk, cause spasms or pain that interfere with function and sleep. In young kids with developing bones, spasticity can also cause twisting bone deformity, hip joint problems (hip dysplasia) and abnormal spinal curvature (neuromuscular scoliosis).
The lowest portion of your spinal cord turns into a collection of nerves called the “cauda equina,” latin for “horse’s tail.” Injury to the cauda equina leads to flaccid tone rather than spasticity or spastic tone.
What can make Spasticity worse?
Spasticity can be influenced by many things including cold temperatures, pain, constipation, medications, sleep, mood and infections or illness. Despite these transient or temporary increases or reductions in spasticity, the baseline spastic tone of affected muscles does NOT change over the lifespan
. This is because spasticity is (typically) the result of a permanent injury to the brain or spinal cord injury. However, during times of rapid growth, such as during puberty, the muscles can quickly become very tight as the bones lengthen rapidly pulling even moreso on these tight muscles. This can be a time for aggressive treatment!
So how do we treat Spasticity?
There is no cure for spasticity but there are MANY things that CAN greatly reduce spasticity and prevent or eliminate the problems it can cause.
- Conservative interventions -> Examples include movement and stretching, bracing, serial casting and positioning.
- Oral medications -> #1 option is oral baclofen.
- Injections -> Botox, Dysport and other types of botulinum toxin can be effective for a select number of muscles.
- Baclofen pump -> Is a very effective therapy that requires surgical pump placement and ongoing physician management, programming and pump refills. It is a reversible intervention meaning the pump can be removed if we no longer wish to use it.
- Selective dorsal rhizotomy -> A permanent neurosurgical procedure performed at select specialty pediatric medical centers that can greatly reduce spasticity. It can lead to significant sensory and movement issues and requires intensive, prolonged rehabilitation.
- Orthopedic surgery -> There are various bone and soft tissue procedures that our Orthopedic surgeons can perform to improve walking, movement, joint contracture, hip or spine problems.
*Other conservative options can include acupuncture, acupressure, chiropractic manipulation, E-stim, heat therapies, other soft tissue therapies (ex: Reiki, Airrosti, simple massage), vestibular therapy, vibration plates.
So what is the best option for my child?
There is no “one size fits all” approach. Talk to your physician about the options and which ones may be helpful for your child now and in the future