According to a new guideline by the UK’s National Institute for Health and Clinical Excellence (NICE), aiming to improve the mobility and comfort of young people below the age of 19 with spasticity, spastic children and teenagers should receive a prompt assessment by physiotherapists (US term: physical therapists).

Almost 24,000 children and teenagers in England and Wales have been diagnosed with spasticity.

The new guidelines recommend that healthcare professionals promptly refer all young people diagnosed with spasticity to physiotherapists without delay. These healthcare providers should develop management programs with young people and their parents, or caregivers, in order to offer individual and goal-focused strategies.

One of the members of the development group that assisted in writing the new guideline was Stephanie Cawker, a clinical specialist physiotherapist at London’s Great Ormond Street Hospital for Children. She said:

“I’m delighted that physiotherapy is so central to the guideline and that it’s recognized not only as a baseline therapy but also as essential to maximizing the effect of other spasticity treatments.”

“It’s good practice for physiotherapists to work in partnership with children and their families and this guideline provides recognition that the management of spasticity is very individual and needs to be specific to each child and family.”

She pointed out that the guideline’s advice would assist local networks in developing clearer methods of care that could support families and help therapists to access resources that are available.

Spasticity is a state of raised muscle tone, as well as an increase in deep tendon reflexes. A patient with spastic paraplegia (spasticity of the legs) has increased leg muscle tone; they feel tight and rigid, and there are exaggerated knee jerk reflexes. The symptom of hipertonia is commonly used when describing spasticity – this refers to abnormally high muscle tension, and difficulty in stretching the muscle.

Experts say hipertonia is caused by lesions in the upper motor neurons in the CNS (central nervous system), which carry data from the CNS to the muscles and control reflexes, muscle tone and posture.

Written by Petra Rattue