Praxis Medical Insights

Non-Pharmacological Interventions

Range-of-motion exercises should be initiated immediately to prevent contracture progression in spinal cord injury patients, as recommended by the American Heart Association/Stroke journal 1
Antispastic positioning and proper body alignment reduce reflex hyperexcitability in spinal cord injury patients, according to the American Heart Association/Stroke journal 1
Stretching programs and splinting help maintain joint mobility and prevent fixed contractures in spinal cord injury patients, as stated by the American Heart Association/Stroke journal 1
Botulinum toxin injections target specific muscles causing contracture in patients with focal spasticity, as recommended by the American Heart Association/Stroke journal 1

Baclofen is FDA-approved specifically for spasticity from spinal cord injuries and is particularly effective for flexor spasms and concomitant pain, with a starting dose of 5 mg three times daily, as recommended by the American College of Physicians/Praxis Medical Insights 2
The American College of Physicians/Praxis Medical Insights recommends avoiding benzodiazepines (diazepam) during recovery phases as they may negatively impact neurological recovery 2

When initiating baclofen therapy, monitor closely for muscle weakness that could impair residual function, as advised by the American College of Physicians/Praxis Medical Insights 2
The American College of Physicians/Praxis Medical Insights advises monitoring for urinary function changes when initiating baclofen therapy 2
Cognitive effects and sedation should be monitored when initiating baclofen therapy, as recommended by the American College of Physicians/Praxis Medical Insights 2

Intrathecal baclofen via programmable pump delivers drug directly to spinal cord for severe, refractory spasticity, as recommended by the American Heart Association/Stroke journal 1