Paralysis is the loss of all or part of a muscle’s ability to move.
There are several types of paralysis that can result from neurological damage, such as a stroke or spinal cord injury, including spastic paralysis (produced by increased muscle tone) and flaccid paralysis (caused by reduced muscle tone).
You must be able to distinguish between spastic and flaccid paralysis in order to receive the appropriate care and improve your chances of recovery.
This article will outline the most effective methods for promoting muscle mobility in injured areas and make the distinction between spastic and flaccid paralysis.
✅ Stroke and spinal cord injury are the two main causes of paralysis.
✅ To create a successful rehabilitation plan, it is imperative to differentiate between flaccid and spastic paralysis.
✅ Your treatment strategy may alter based on the type and degree of your paralysis.
✅ However, everyone can benefit from passive exercises that encourage nervous system stimulation and neuroplasticity activation.
How Does the Nervous System Control Muscle Movement?
You can distinguish between spastic and flaccid paralysis by being aware of how the neurological system influences muscular movement.
The nervous system is made up of the peripheral and central nervous systems. The central nervous system is made up of the brain and spinal cord, which are the organising, coordinating, and planning organs that control most of our daily activities.
The peripheral nervous system emerges from the spinal cord and links the brain and the rest of the body. It sends signals from the brain instructing the muscles to contract or relax as well as data regarding sensation back to the brain for processing.
Motor neurones play a crucial part in the transmission of signals relating to muscle movement by creating complex circuits all across the body and transmitting messages concerning both voluntary and involuntary movement.
The following signals are sent via the following sequential pathway to activate the muscles:
- The motor cortex of the brain (initiates motor signals)
- Increased motor neurones (transmits motor signals from the brain through the spinal cord)
- More compact motor neurones (connects with an upper motor neurone in the spinal cord, then transmits motor signals to muscles throughout the body)
Injury to this neural circuit may result in flaccid or spastic paralysis. Paralysis is the absence of motor function in one or more body components.
For instance, when higher motor neurones are injured, spasticity (muscle stiffness) or spastic paralysis may ensue. A lower motor neurone injury, on the other hand, can result in twitching, flaccid paralysis, muscular atrophy, or weakness.
What causes paralysis?
There are numerous neurological conditions that can result in paralysis. Studies show that the leading causes of paralysis are spinal cord injuries and strokes, which account for 33.7% and 27.3% of cases, respectively. Other possibilities include cerebral palsy, multiple sclerosis, and traumatic brain injury.
Paralysis comes from damage to the brain’s motor control areas after a stroke. Each hemisphere of the brain controls movement on the opposite side of the body. Therefore, paralysis brought on by a stroke typically results in hemiplegia, or paralysis on either the right or left side of the body, opposite the area of brain injury.
After a spinal cord injury, paralysis occurs because damaged nerves’ capacity to communicate with the brain is disrupted. Quadriplegia or paraplegia (paralysis of the lower limbs) could arise from this (paralysis in all four limbs).
Depending on the size and location of the lesion, those who survive a stroke or spinal cord injury may experience either spastic paralysis or flaccid paralysis.
Differentiating between Spastic and Flaccid Paralysis
Although both spastic paralysis and flaccid paralysis restrict the voluntary movement of the muscles, they are two quite different types of paralysis.
One notable difference is that the muscles are permanently constricted in spastic paralysis, causing rigidity and immobility. In contrast, the muscles are unable to contract in flaccid paralysis, becoming floppy and immobile as a result. Despite the fact that the fundamental causes of spastic and flaccid paralysis are distinct from one another, the muscles become immobilized in both conditions.
Spastic paralysis can be brought on by injury to the higher motor neurones, which leads to a loss of voluntary control over the affected muscles. In spastic paralysis, the signals that tell the muscles to contract or relax are out of balance. The muscles tighten and become harder as a result. As a result, survivors could have muscle twitching, spasms, or stiffness.
Flaccid paralysis occurs when the lower motor neurones are damaged because nerve signals cannot reach the targeted muscles. There is neither involuntary nor voluntary control over the muscles in flaccid paralysis, therefore the muscles do not move at all. Flaccid paralysis lowers muscle tone, tension, or resistance to movement.
Additionally, it causes muscles to relax and contract less. Both spastic paralysis and flaccid paralysis have unique characteristics. It’s critical to develop the ability to distinguish between them in order to obtain the proper care.
How Passive Exercises Can Help Spastic and Flaccid Paralysis
A neurological injury can cause the neuronal circuits inside the nervous system to be damaged, leading to spastic or flaccid paralysis. To make new connections in the brain and strengthen old ones, neuroplasticity must be activated.
Neuroplasticity is the term used to describe the nervous system’s capacity for self-healing and rewiring. Restoring connections leads to improved communication between the nervous system and the muscles. The likelihood of restoring movement and reducing paralysis increases as a result.
The best approaches to increase neuroplasticity are through exercises that require a lot of repetition or group practice. As an ability is used, the nervous system will become more aware of its importance and repair neural connections for it.
The ideal kind of exercise for those with limited or no motion is passive exercise. Active exercises are performed using your own energy, whereas passive activities require the support of your unaffected limbs or that of a trained caregiver or therapist.
Even if you are unable to move your own muscles, passive workouts can help by stimulating neuroplasticity by transmitting signals to the nervous system, which is essential for recovery from spastic and flaccid paralysis.
Treatment of Spastic Paralysis vs. Flaccid Paralysis
Treatment for spastic vs. flaccid paralysis may vary depending on the severity. However, both require equal attention and treatment as quickly as feasible in order to halt further harm or issues. If flaccid paralysis is left untreated, the muscles may start to deteriorate (reduce in size and waste away).
Spastic paralysis left untreated can lead to frozen joints, shortened tendons, and immobile limbs.
More serious issues like contractures or skin sores may develop if paralysis is not treated. In order to reduce the likelihood that spastic or flaccid paralysis would progress or encounter catastrophic issues, a sound rehabilitation exercise plan must be in place.
This can include a variety of rehabilitation exercises for spastic and flaccid paralysis, including:
- Passive range-of-motion exercises: these exercises stimulate the neurological system and neuroplasticity. The majority of rehab tasks can be converted to passive ones with the help of your unaffected limbs or a therapist. Passive exercise often focuses primarily on increasing the range of motion in the damaged joints. It also increases muscle flexibility, decreases stiffness and spasticity in those with spastic paralysis, and prevents contractures and pressure sores. Exercises for passive range of motion can increase the likelihood that someone with flaccid paralysis will fully recover.
- Physical therapy: emphasizes targeted activities to increase the functional mobility of the injured muscles. Movement is necessary to keep the nervous system active, prevent muscular atrophy, and lower the risk of numerous illnesses associated with paralysis.
- Occupational therapy: Emphasizes restorative and compensating skills to carry out daily duties and maximize independence. Daily chores may be challenging if you have spastic or flaccid paralysis, but you can still accomplish them with the use of a variety of occupational therapy techniques, such as turning on and off a light switch. Adaptive equipment can also be helpful when using your unaffected muscles to eat or take a bath.
- Home therapy exercises: These are meant to keep you inspired to keep doing them over and over again while encouraging neuroplasticity in between outpatient therapy sessions. Along with exercise sheets, home therapy may also involve the use of neurorehabilitation gadgets like FitMi and MusicGlove, which can be used passively to help improve flaccid and spastic paralysis.
Aside from paralysis rehabilitation exercises, certain patients could benefit from additional treatments. Depending on the level of paralysis, these include:
- Medication: Post-paralysis symptoms like pain and hopelessness can make it less appealing to seek rehabilitation. To treat pain and/or sadness, doctors may prescribe painkillers or antidepressants. They could also suggest prescribing muscle relaxants for spastic paralysis due to the increase in muscular tone.
- Splints or Orthotic Devices: In paralyzed individuals, splints or orthotic devices can aid in establishing proper muscular alignment, providing support for the joints, and/or gently stretching spastic muscles. Consult your doctor or therapist to choose the appropriate type of orthotic for you.
- Botox: Botulinum toxin, also referred to as Botox, is a medication used to treat spasticity and unwind stiff muscles. Since it doesn’t treat flaccid paralysis, it might be helpful for treating spastic paralysis. It works by blocking the nerve signals that trigger unintended muscle contractions.
- Surgery: According to research, physical therapy and enhanced nerve surgery techniques may be useful in treating paralysis caused by a spinal cord injury, notably in the hands and arms. Surgery is an extremely invasive operation that needs to be reserved for the absolute last resort when all other options have failed.
- Electrical Stimulation: This is a promising treatment for flaccid and spastic paralysis. During electrical stimulation, electrodes are placed on the skin’s surface over the damaged muscles. The next step is for a therapist to apply electrical stimulation while modifying the frequency and intensity with a device. Electrical impulses contribute to the contraction and movement of muscles. Studies show that electrical stimulation and exercise for rehabilitation are much more effective when used simultaneously.
- Electroacupuncture: This method combines acupuncture with electrical stimulation. Once the needles have been put into certain bodily regions, electrical stimulation is progressively applied to them to perform their function. The more stimulation your body experiences, the more it can help engage the brain system and promote muscular activity.
When used in conjunction with therapeutic activities, orthotic devices, electrical stimulation, and electroacupuncture are the most effective. Ask your therapist which therapeutic approaches are safe and suitable for your issue.