Spasticity, caused by a variety of injuries and disorders, can be a significant source of pain and discomfort for your child or teen. The Mary Free Bed Pediatric Spasticity Management Assessment Clinic focuses on developing one- to two-year management plans for young patients experiencing a muscle control disorder because of conditions like spinal cord injury, cerebral palsy, brain injury, multiple sclerosis and stroke.

Your child or teen will receive comprehensive services and spasticity treatment based on his or her goals for therapy. Evaluations are given on a monthly basis. A multidisciplinary team collaborates to promote your child’s freedom and independence in areas like mobility and self-care. Family education is a key component of our program and we’ll ensure you, your child, your child’s physician and other health-care providers understand the therapy plan.

Children with severe problems with spasticity, such as those cause by cerebral palsy or other disorders, may find help through our Advanced Management of Pediatric Spasticity Program (AMPS). Learn more about AMPS, here.

Your child’s treatment begins with a thorough evaluation from his or her physician and therapists. Management begins conservatively with a home exercise program. Therapy becomes more complex as the team determines the most appropriate path to spasticity management, which may include:

• Physical therapy with special stretching, strengthening and range-of-motion exercises
• Oral medications (such as baclofen, Zanaflex, Dantrium and Valium, alone or in combination) in cases where spasticity persists despite stretching and other physical therapies
• Serial casting
• Splinting
• Functional skills training
• Orthotics consultation and ongoing adjustments

Intrathecal baclofen (a method that delivers the medication baclofen directly into the spinal fluid of your back) may be considered as a treatment option. This medication may relieve muscle spasms, cramping and tightness. A test dose will be administered here at Mary Free Bed during a short inpatient stay.

Your child’s physician, nurse and physical therapist will evaluate the effectiveness of the medication and monitor your child’s reaction to it. They’ll focus on things like your child’s respiratory status, mobility and spasticity.

If your child has a positive response to the medication and it’s agreed to proceed, your child will receive a referral to a neurosurgeon. This specialist will conduct the consultation and placement of the pump. Once it’s in place, the pump can be monitored on an ongoing basis for dose adjustments and refills at Mary Free Bed.

Our Pediatric Spasticity Clinic specialists work closely with your child’s physician and your family to provide comprehensive care. Your child’s treatment team may include:

• Physiatrist – a physician specializing in physical rehabilitation medicine will manage your child’s medical care and direct his or her spasticity rehabilitation team.
• Occupational therapist – an occupational therapist will focus on upper limb movement, daily living activities and making recommendations for special adaptive equipment and splinting.
• Orthotist – a specialist with extensive experience in orthoses for spasticity management will provide expertise in customizing and fitting orthoses to help with comfort and activity.
• Physical therapist – a physical therapist will provide consultation, treatment, evaluations and hands-on therapy as appropriate for your child’s care.
• Rehabilitation nurse – a nurse will develop and oversee your nursing care plan with a focus on self-care, comfort and education, while also collaborating with the Mary Free Bed inpatient nursing team to provide round-the-clock coverage of intrathecal baclofen issues.


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Health care providers: click here for information about Intrathecal Baclofen Emergency Algorithms (ITB) and Autonomic Dysreflexia (SCI above T6).