Many of the clients that attend Advance Rehab Centre with neurological impairments will present with clonus. Clonus looks like repetitive bouncing and is an involuntary, rhythmical, contraction and relaxation of a muscle or muscle group, most commonly seen in the muscles at the end of a limb such as the calf mucles. Clonus is normally stimulated by touch or movement, in the case of the ankle, it may be stimulated from just repositioning the foot on the ground.
Clonus is typically seen in patients following stroke, traumatic brain injury, spinal cord damage, multiple sclerosis or other acquired brain injury, however a new occurrence of symptoms of clonus should be investigated by a neurologist. Clonus is associated with mild to moderate spasticity, but not with significantly increased spasticity, due to the muscle being in a constant state of activity and unable to switch on/off.
Clonus can be very distressing for many people and is often managed through physiotherapy treatments which can involve stretching and strengthening of the affected muscle group. In cases of significant loss of range splinting and serial casting can be considered to increase muscle length as this can decrease the sensitivity of the clonus.
If the clonus is affecting function and positioning, pharmacological treatments can include immune-suppressants, anticonvulsants and tranquilizers, most commonly clonazepam. Injections of botulinum toxin to paralyse the affected muscle can also be used. This is often done in conjunction with a physiotherapy program as this leads to weakness of the muscle which may also affect function.
In severe cases surgery to cut tendons or cut the nerve supplying the affected muscle.
If you experience clonus and it is interfering in your rehab and every day activities then please call the centre as we may be able to help you.