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Physical Medicine and Rehabilitation

Spasticity Management Program

Overview

Spasticity Management from Leading Boston Physiatrists

The Spasticity Management Program at Floating Hospital for Children provides personalized care to children and adolescents who have pain, discomfort or physical limitations caused by spasticity. Our physiatrists have decades of experience in treating children with Botulinum toxin (Botox) therapy, phenol therapy, intrathecal baclofen (ITB) pumps and a wide range of advanced, non-surgical techniques — all delivered with warmth, understanding and personal attention your child will find reassuring.

Our expert team includes:

  • Harry Webster, MD, FAAP, Chief of Pediatric Physiatry, is our program director and  the founder of the first clinic using Botox therapy to treat children with spasticity in New England. Since 1984, he has cared for children whose everyday lives are affected by spasticity problems, especially those who have cerebral palsy.
  • Joining Dr. Webster is Patrick Brennan, MD , who is experienced in using the latest, advanced methods in managing spasticity and also treats children in our Cerebral Palsy and Brain Injury programs. Dr. Brennan is a former medical director of the pediatric unit at Spaulding Rehabilitation Hospital, where he managed teams that cared for children with traumatic brain injury, spinal cord injury, stroke, brain tumor and multiple trauma.
  • Our nurse practitioner, Lucia Bastianelli, RN, MSN, CPNP , has not only mastered the science of managing minimally invasive Botox and phenol procedures, but also the art of caring: Her thoughtful and gentle manner helps both children and parents remain calm and comfortable before, during and after procedures and refills of ITB pumps.

The Personalized Approach to Managing Spasticity

The methods we use to manage spasticity are based on an in-depth evaluation of your child, which leads to a carefully designed, personalized treatment plan. Each child’s needs are different, and our treatment approach reflects your child’s uniqueness. We select and use the right combination of therapies to help your child reach his or her goals, such as staying in school, exercising, playing and building friendships.

Traditional, Non-Surgical Methods

Depending on the severity and frequency of your child’s spasticity problems, we may use traditional, physical methods of management, such as therapeutic heat, cold and electrical stimulation, in combination with the latest in effective physiatric techniques, which reduce hyper-tonicity (abnormally tight muscle or muscles).

Some of the other typical treatments options we may prescribe include:

  • Exercise programs
  • Stretching
  • Bracing
  • Splinting
  • Oral medication

Botox and Phenol Injections and Intrathecal Baclofen Pump (ITB) Therapy

For many patients, injecting  their muscles with Botox or phenol can temporarily alleviate spasticity. How long the benefit of these injections lasts depend on the severity of your child’s condition, the dose of medication and other factors.

Botox or phenol is often prescribed to temporarily suppress spasticity so your child can participate in physical therapy and exercise, work on communications skills and pursue other goals. Additionally, these medications  can relieve spasticity in some children  for longer periods. Botox injections, for example, can be effective for up to six months.

For children with severe spasticity, an ITB pump can be effective in controlling spasticity on a daily basis. After the ITB pump is surgically implanted in the abdomen, it continuously releases baclofen into the body to manage spasticity 24/7.

Surgical Treatments

When spasticity or contractures shorten tendons, we may use bracing to correct the problem, or we may recommend a procedure such as:

  • Tenotomy
  • Tendon-lengthening procedures
  • Tendon transfers

These tendon procedures are performed by expert surgeons in Pediatric Orthopaedics, who work closely with us and are just a few steps from our office space in Floating Hospital. The orthopaedists at Floating Hospital also treat patients whose disabilities lead to arthritis, scoliosis and other musculoskeletal problems.

Multidisciplinary Care for Spasticity

A major advantage of coming to our physiatry department is that we work closely with a wide range of experienced pediatric specialists here at Floating Hospital for Children and in your community.

Depending on your child’s need and goals, we may also collaborate on his or her care with experts in areas such as:

Doctors + Care Team

Harry C. Webster, MD, FAAP

Harry C. Webster, MD, FAAP

Title(s): Physiatrist-in-Chief; Chief, Pediatric Division of Physical Medicine and Rehabilitation; Assistant Professor, Tufts University School of Medicine
Department(s): Physical Medicine and Rehabilitation, Pediatric Physical Medicine and Rehabilitation
Appt. Phone: 617-636-5626
Fax #: 617-636-5056

Pediatric rehabilitation, spasticity/tone evaluation and treatment, long-term care of chronically impaired children, transition of disabled children to adult services, muscular dystrophy, cerebral palsy, orthotics for gait disorders, pediatric orthotics

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Patrick J. Brennan, MD

Patrick J. Brennan, MD

Title(s): Pediatric Physiatrist; Instructor, Tufts University School of Medicine
Department(s): Physical Medicine and Rehabilitation, Pediatric Physical Medicine and Rehabilitation
Appt. Phone: 617-636-4887
Fax #: 617-636-5056

Cerebral palsy, traumatic brain injury, spinal cord injury

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617-636-5626