Contracture is the adaptive shortening to the muscular structures exacerbated by immobility of a joint. It is caused by secondary complications of spasticity following nervous system damage and is common in conditions such as acquired brain injury, spinal cord injury, cerebral palsy and multiple sclerosis.

Contracture can be painful, reduce range of movement, cause pressure damage and reduce independence and function. To limit adverse effects and aid maximal function and independence it is important to treat spasticity.

One treatment for this is the use of functional electrical stimulation (FES) post botulinum toxin injection. Earlier this year guidelines for spasticity in adults: Management using botulinum toxin were published by The Royal College of Physicians.

Electrical stimulation

The guidelines highlighted the evidence base post-injection management and, are supportive of the use of electrical stimulation. They suggest that “Consideration of other treatments that may enhance the effects of Botulinum Toxin Type A (BoNT-A), such as constraint therapy or electrical stimulation as appropriate.”

It also said, “There is some evidence that electrical stimulation of the injected muscle may enhance the anti-spastic effects of BoNT-A (Hesse, Reiter et al 1998)”. Furthermore, “Functional electrical stimulation of the antagonist muscle may help to build up muscle strength and so enhance functional benefits (Hesse, Reiter et al 1998).” This suggests that electrical stimulation may be used in the agonist and antagonistic muscle after Botulinum toxin injection.

Valuable tool in managing spasticity

The Xcite is a FES device which offers up to 12 channel electrical stimulation to provide stimulation to the agonist and antagonistic muscle. The Xcite can be a valuable tool for clinicians in using after Botulinum toxin injection for the management of spasticity.

For more information on how the Xcite can be used after a Botulinum toxin injection please contact Matt White by filling out the form at the bottom of this page.

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