Multimodal treatment in spasticity management: an educational case-based international perspective

The understanding of spasticity has evolved to recognize the complex interaction between hyperkinetic and hypokinetic mechanisms. Disruptions in upper motor neurons lead to an imbalance in excitatory and inhibitory pathways, increasing muscle tone and hyperreflexia, while hypokinetic factors contribute to structural decline. This article presents a case-based framework that integrates visual aids to support a patient-centered, goal-oriented, and multimodal treatment approach addressing both hyperkinetic and hypokinetic components. By combining pharmacological, orthotic, and rehabilitative interventions, this strategy improves clinical and functional outcomes. The authors endorse this evidence-based approach, offering a practical model adaptable across health care settings for clinicians worldwide.