Abstract
Limb usage after head injury is often impaired by structural pathologies such as muscle contracture, and by heterotopic bone and functional pathologies such as abnormal motor control associated with disturbances of muscle tone. Spasticity is probably the most common disturbance of tone after head injury, and has been studied with the technique of dynamic poly-electromyography. During the performance of functional limb movements which are marked electronically, patterns of EMG are recorded simultaneouslyfrom multiplemuscles and then interpretedby the examiner in correlation with in vivo and videotaped observations of motion. Electrokinesiologic assessment of "weak" agonists, "spastic" or "co-contracting" antagonists and their temporal and spatial combinations helps identify a therapy rationale. Treatment approaches may include selective nerve and motor point blocks and the surgical transfer and release of specific muscle groups. The author emphasizes that the decision to treat spasticity and other abnormal motor phenomena must be based on how they influence targeted functional goals of the rehabilitation plan.