In individuals with Friedreich ataxia, spasticity and muscle spasms — including those occurring at night — are a recognised clinical challenge that warrants structured, stepwise assessment and management.
People with Friedreich ataxia benefit from assessment for spasticity, pain, and spasms, including nocturnal spasms, as well as for incipient or established contracture. This protocol is directed at exactly this presentation.
Management begins with non-pharmacological physiotherapy — including strengthening and stretching — as the preferred first step before other options are considered. The complete structured regimen, including how rehabilitation interventions interact with further steps, is available in the full protocol.
People with Friedreich ataxia benefit from assessment for spasticity, pain and spasms (including nocturnal spasms) and incipient or established contracture.
We suggest non-pharmacological (physiotherapy) treatment, such as strengthening and stretching, should be used as a first option in the management of spasticity (and its secondary consequences such as mobility decline), prior to considering pharmacological interventions for individuals with Friedreich ataxia with spasticity.
We suggest physiotherapy/rehabilitation interventions (such as strengthening, stretching, serial casting and standing machine stretch) are used to enhance the effects of pharmacological therapy for management of spasticity in individuals with Friedreich ataxia.
DOI: 10.1186/s13023-022-02568-3
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