Triggers and aggravating factors of spasticity include factors that generally lead to discomfort or that lead to increased arousal of neurological activity.
Triggers include:
- Sensation: touch sensitivity can lead to brief spastic response.
- Movement: passive movement of limbs or motion in a car or wheelchair.
In patients with sustained increase in spasticty the first clinical action to take is to review skin condition, seating posture and bladder/bowel function, looking for treatable trigger factors.
Aggravants include:
- Pain e.g. from a pressure ulcer or in-growing toenail.
- Bowel dysfunction: most commonly constipation or faecal overloading
- Bladder dysfunction: usually retention, catheter related discomfort, urinary tract infection or calculus.
- Environment e.g. cold temperature.
- Seating position.
- Anxiety.