Spastic hand treatment relies mostly on a diagnostic analysis of the various function deficits.
These hand function deficits are of different types:
- paresis itself which corresponds to the deficit in active muscle motion
- spasticity corresponding to hypertonia (permanent muscle contraction)
- muscle shrinkage, corresponding to reduced muscle length, as a result of prolonged spasticity
- control disorders, corresponding to inaccurate use of muscles, sometimes associated with cognitive disorders
- bone and joint deformity, encountered mainly in children and teenagers, corresponding to bone growth disorders
- sensitivity and pain perception anomaly must be qualified, abnormal sensitivity in itself often constitutes a substantial deficit
The clinical examination (consultation) is the cornerstone of the diagnosis.Consultation is quite long and may have to be repeated to ensure the diagnosis is as complete as possible.
In this diagnostic analysis, truncular anaesthesia of the various nerves may be carried out to distinguish spasticity from muscle shrinkage.
Once the diagnosis is established, a realistic therapeutic scheme can be defined with the patient.