Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and can interfere with normal movement, speech and gait. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement.
Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood.
The module leads were Gillian Alexander (AHP Stroke Consultant, NHS Greater Glasgow and Clyde) and Mark Smith (AHP Consultant in Stroke, NHS Lothian).
Over the last nine months the Interactive Content team have worked in partnership with Chest Heart & Stroke Scotland (CHSS) and NHS Scotland to produce the 19th e-learning stroke advancing module for the open access Stroke Training and Awareness Resources (STARs) website.
Management of Tone & Spasticity After Stroke: A Role for Everyone
This training module focuses on providing healthcare professionals with an increased understanding of abnormal tone after stroke, how to identify tone changes, managing abnormal tone and specialist spasticity services.
The module was written by a team of authors led by Mark Smith, AHP Consultant in Stroke, NHS Lothian and Gillian Alexander, AHP Stroke Consultant, NHS Greater Glasgow and Clyde. The project was managed by Fran Bailey, e-learning project manager at CHSS. Jackie Aim was the project lead for the Interactive Content team.
Over the course of the nine months there were several author group meetings and workshops held at CHSS. The meetings included invaluable input from experienced professionals selected by CHSS. In addition to Mark and Gillian, the author group included:
- Charlie Chung, Stroke Clinical Specialist Occupational Therapist, NHS Fife
- Niall Hughes, Consultant Physician, NHS Greater Glasgow and Clyde
- Susie Hughes, Advanced Specialist Orthotist, NHS Greater Glasgow and Clyde
- Irene Nicol, Specialist Nurse, NHS Lothian
- Debbie Strang, Specialist Physiotherapist, NHS Lanarkshire
Once the content was finalised it was further reviewed by a number of top healthcare professionals across Scotland to ensure it met the learning outcomes.
Developing a module that focuses on tone and spasticity
The ‘Management of Tone & Spasticity After Stroke’ module is comprised of several different sections: normal movement and anatomy of muscle, treatment, specialist spasticity services, a fictional case study and the module test.
In the case scenario the learner follows Dave (virtual patient) in two different ways at the same time. This leads to different consequences and outcomes for muscle tone and spasticity in each version of Dave (similar to the film ‘Sliding Doors’). One version of Dave goes to an acute stroke unit and the other Dave goes to a general ward. In both versions Dave is seen at the accident and emergency department.
The decision was made early on that the best way to focus on understanding and identifying tone and spasticity would be to film a person who had actually experienced a stroke. Fran sourced a volunteer who was happy to be filmed, Allan Ritchie had taken part in filming before and features in the BMA highly commended ‘Self Help 4 Stroke’ resource. Mark Smith describes and shows us the details of Allan’s tone and spasticity, this illustrates the importance of identifying and managing tone. The filming was carried out by John Archer who has been previously involved in several CHSS video productions.
All of the 14 H5P OERs (open educational resources) contained within this module are Creative Commons BY-NC-SA licensed.
Copyright © Chest Heart & Stroke Scotland and The University of Edinburgh 2017 CC BY-NC-SA
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.