Spasticity is a common complication of stroke that results in impairments and limitations in performance of activities and participation. Although it is an important problem, spasticity, defined as velocity-dependent muscle overactivity, is only one component of the upper motor neuron syndrome (UMNS). It is often related to other motor impairments, such as weakness, and disordered motor control, which magnify the functional impact of spasticity. The mere presence of spasticity is not enough reason to initiate treatment. A thoughtful assessment of the clinical picture and functional impairment is the first step in establishing a management strategy, followed by treatment goal setting. Patient engagement in goal setting is an important component of a collaborative management with the clinician. Various pharmacologic and surgical interventions have been used for a different clinical situations and indications with varying outcomes. The related evidence is presented, and specific practice recommendations are provided.
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