Non-pharmacologic interventions for spasticity associated with multiple sclerosis

Spasticity is a common disabling symptom in people affected by multiple sclerosis (MS). It is estimated that between 40% and 75% of patients with MS are affected. The hyperexcitability of the stretch reflex arc with α- and γ-motor neurons hyperactivity is reported to explain the increase of the muscle tone. Medical management of spasticity includes pharmacologic, physical therapeutic and surgical approaches. In the initial phase of the disease, spasticity is usually mild to moderate and can be managed by exercise, physiotherapy and changes in daily activities. However, there is still a need for clinical studies to find the real effectiveness of physical therapy in spasticity due to MS.