Scientific Basis of the Use of Medical Rehabilitation and Botulinum Therapy during Rehabilitation Post-Stroke Spasticity

Among the factors contributing to disability after stroke is the most important movement disorder, major clinical manifestation of which is the central spastic paresis. Spasticity is revealed in the study of passive movements of the limbs as increased resistance to muscle in response to its rapid stretching. Once developed spastic paresis usually persists throughout the life of the patient. The treatment of spastic paresis is intractable problem. In recent years the treatment of post-stroke spasticity started using botulinum toxin type A. In comparison with the existing methods of treating muscle hyper local administration of botulinum toxin has a number of obvious advantages. According to the latest recommendations in all cases after botulinum therapy require active physical therapy and physical rehabilitation. Botulinum therapy is not a substitute for physical therapy and exercise therapy, which is the basis of the rehabilitation program and is an integrated part of a comprehensive treatment to improve motor functions. Using a special additional treatment measures such as physical therapy and exercise therapy is often part of the overall treatment but their formal evaluation was carried out in only a few studies. The article presents the author´s concept of rehabilitation post-stroke spastic muscle hypertonus in neuro-rehabilitation with the use of medical rehabilitation and botulinum therapy.