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1. Spasticity is abnormal, velocity-dependent resistance to passive movement of affected muscles at rest.

2. Usually seen days to weeks post-ischemic stroke, follows UL flexor & LL extensor patterns.

3. Spastic equinovarus is the most common presentation, most frequently encountered during the terminal swing and stance phase.

4. Lower limb spasticity may aid hemiplegic patient to weight-bear on affected leg during stance phase.

5. Primary goals of treatment are improvement in gait velocity and quality, reduced pain and improved posture.

6. Spasticity in the hemiplegic lower extremity is generally not treated, unless it impacts function and results in significant pain.

7. Main indication for treatment of lower extremity spasticity is equinovarus, caused by spasticity of the gastrocnemius and tibialis posterior muscles.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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