Abstract
Spastic paresis is a major symptom in most acquired brain injuries. The paper first discusses reactions of brain to damage and spontaneous neuroplastic changes in central nervous system.
It further reviews recent knowledge on the field of rehabilitation of motor functions after acquired brain injury in flaccid stage emphasizing paresis which dominates in this stage. The second part of the paper describes various types of muscle overactivity (spasticity, spastic dystonia, flexor and extensor spasms, spastic co-contraction and spastic synkinesis) and defines the goals of rehabilitation in spastic stage with respect to the current stage of knowledge about induced neuroplastic changes in the central nervous system.
Finally therapeutic modalities for the treatment of three major symptoms of upper motor neuron syndrome (i.e. muscle shortening, muscle overactivity and stretch-sensitive paresis) are presented including the concept of Prof. Gracies' Guided Self-rehabilitation Contract which the authors follow.