PITTSBURGH, October 22, 1999 — More than 500,000 people in the United States with neurological disorders such as multiple sclerosis or cerebral palsy or who are recovering from stroke or brain or spinal cord injury also experience a frustrating side effect called spasticity .
Spasticity is the loss of muscle control, loss of muscle tone and long-term muscle shortening in the arms or legs that causes involuntary spasms, pain, stiffness and immobility. These abnormal muscle contractions happen when nerve signals do not travel properly from the brain to the muscle. Spasticity can severely disrupt a person’s quality of life because it limits mobility and the ability to take care of oneself and carry out simple activities of daily living, such as personal hygiene, eating, dressing, driving a car or typing on a computer keyboard.
Because spasticity can be caused by such an array of neurological disorders, efficiently seeking the various available treatments for spasticity can be confusing and frustrating for patients, their physicians, families and caregivers.
To streamline all of the available clinical treatments for spasticity – no matter what the cause – and coordinate staff resources and services under one hub, University of Pittsburgh Medical Center has established an adult Spasticity Evaluation and Treatment Center.
"The biggest benefit for patients is this unique central coordination of care by the spasticity specialist team, including physicians, nurse practitioners, physical therapists and occupational therapists," said Michael C. Munin, M.D., assistant professor within the division of physical medicine and rehabilitation at the University of Pittsburgh School of Medicine and medical director of the Spasticity Center.
"Often, patients with spasticity do not know where to turn for treatment and their primary physicians may not have the equipment or staff to properly and specifically manage spasticity in the most efficient way. The new center prevents patients and their primary physicians from having to search on their own for spasticity specialists to treat their particular neurological problem," said Dr. Munin. The center’s team coordinates referrals for all patients and communicates with primary care providers, outlining the evaluation and treatment options.
Another unique advantage for patients is the team’s emphasis on education, according to Donna Levitt, CRNP, program manager. "Our main goal is to make sure people know that no matter what the primary disease or disorder is, there are good treatment options for spasticity," she said.
Among the center’s treatment options are: anti-spasmodic oral medications; physical and occupational therapy; bracing and orthotics; botulinum toxin-A or "botox" direct intramuscular injections to reduce spasms; and intrathecal bacolfen therapy, in which a small pump and catheter are implanted under the skin in the lower back so that anti-spasmodic medicine can be delivered into the spinal fluid at precise dosages. The pump can be tailored to deliver medication at any time via computer-controlled mechanisms within the pump.
Coordinated referrals to orthopaedic surgeons for specialized surgery or to neurologists for diagnostic procedures are also provided. Center team members decide with patients, their families and primary care providers which options are the most appropriate and effective for each individual case.
The Spasticity Evaluation and Treatment Center is located in Suite 1103 Kaufmann Building, where patients are evaluated and can receive treatment. Certain treatment options also are available at UPMC Rehabilitation Hospital. To learn more, individuals can call 412-647-2123.