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For the latest cutting-edge research, innovative collaborations and remarkable discoveries in child health, read stories from across all our areas of study in Q: Advances and Answers in Pediatric Health.
Orthopedics
Spasticity and Tone Abnormalities
We treat kids like they should be treated: like kids. That’s why we designed our hospital just for them.
What are the types of tone abnormalities?
- Spasticity: stiffness or increased tone (described in more detail below)
- Dystonia: fluctuating tone with involuntary movements
- Ataxia: tremors and poor control of direction, grading and timing of movements
- Hypotonia: decreased tone or "floppiness"
What is spasticity?
Simply put, spastic muscles are tense and resist movement. Children with spasticity are usually described as stiff, and muscle contractions can happen without voluntary control.
Who gets spasticity and can it be prevented?
Spasticity is a type of increased tone that can be a long-term effect of conditions where the brain and/or spinal cord are damaged or fail to develop normally. These conditions include:
- Cerebral palsy
- Spinal cord injury
- Acquired brain injury
- Stroke
- Multiple sclerosis
There is no cure for spasticity and it cannot be prevented. However, it can be well managed with the proper combination of physical and occupational therapy, medications, injections or surgery.
How does spasticity relate to cerebral palsy?
Spasticity is a common symptom found in kids and adults with cerebral palsy (CP). Spasticity can be difficult to control in children with CP and interferes with movement by affecting smoothness, speed, range of motion and a variety of movement patterns.
What are signs and symptoms of spasticity?
Spasticity is often diagnosed with cerebral palsy or after a brain or spinal cord injury. Spasticity symptoms include:
- Increased muscle stretch reflexes
- Involuntary contraction and relaxation of muscles (spasms)
- Prolonged muscle contractions
- Rapid, repetitive jerky motions
- Exaggerated, deep tendon jerks or reflexes
- Involuntary crossing of the legs
- Abnormal posture or positioning of the shoulder, arm, wrist or finger
- Resistance to movement of certain muscle groups
Spasticity most commonly affects the legs and arms. However, it can affect any part of the body including the trunk, neck, eyelids, face or vocal cords.
To confirm the diagnosis involving a tone abnormality (like spasticity), the following evaluations or tests may be performed at Children's Hospital Colorado:
- Magnetic Resonance Imaging (MRI): MRI uses a powerful magnet to produce a picture of the brain and spinal cord. The procedure takes approximately one hour to complete, and there is no radiation. Because your child must lie very still during the test, he or she may be temporarily sedated.
- Physical and occupational therapy evaluations: Physical and occupational therapists will assess your child’s range of motion, strength, balance, trunk control, selective control, reflexes, equipment, function and mobility.
- Gait evaluation: A video from the Center for Gait and Movement Analysis records your child's walking ability. This gait test helps doctors analyze your child's limb and body movement, muscle activity and energy use while walking.
- X-rays: X-rays create diagnostic imaging (pictures) of the spine and hips.
- Nerve conduction study: This test is commonly used to evaluate muscle or nerve damage.
How is spasticity treated?
At Children's Colorado, options for treating spasticity include:
- Physical therapy
- Occupational therapy
- Oral medications
- Bracing or casting
- Botulinum toxin and phenol injections
- Intrathecal baclofen (ITB) pumps
- A surgery known as Selective Dorsal Rhizotomy (SDR), used to reduce spasticity in the legs
Why choose Children's Colorado for my child's spasticity?
When you choose the Orthopedics Institute at Children's Colorado, your child will be evaluated by a multidisciplinary team of experts that includes a neurosurgeon, a rehabilitation physician, a neurologist and a physical therapist. These specialists work together and bring expertise from the following clinics and programs that help treat spasticity:
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Get to know our pediatric experts.
Emily Sweeney, MD
Pediatrics, Sports Medicine
Ryan Pahlau, PA-C
Physician Assistant
Brian A. Shaw, MD
Orthopaedic Surgery
Gregory Walker, MD
Pediatrics, Sports Medicine