Background and Purpose: Spasticity is defined from the affected muscles’ view point. Velocity dependent stretch responses have been implicated mainly in flexor muscle groups. Optokinetic stimulation stimulates the anti-gravity extensor system in the brain with resultant EMG recordings in the extensor muscles. Preliminary evidence suggests that optokinetic chart stimulation (OKCS) prevents spasticity. A brain anti-gravity extensor system based view point of spasticity has developed. OKCS is a stroke recovery rehabilitation intervention for completely paralysed patients who pose a huge cost to the health and social care economy. The aim is to discuss the effects of OKCS on spasticity and offer a preventative rehabilitation approach for spasticity.

Methodology: OKCS consists of moving an optokinetic chart in front of a patient. The chart consists of repeated colours of the rainbow. From 20 centimetres in front of a patient’s face, the chart is moved from side to side for 3 minutes, up and down for 3 minutes and then forwards and backwards for 3 minutes.

Results: In a case controlled series of 10 participants with complete paralysis as a result of partial anterior circulatory strokes, none of the OKCS participants developed spasticity of the affected upper limb. Four of the 5 conventional physiotherapy participants developed spasticity of the affected upper limb. The differences in spasticity were statistically significant (P<0.05).

Conclusion: OKCS shows preliminary efficacy in preventing spasticity in completely paralysed acute strokes. Its stimulation of anti-gravity extensors may explain this through reciprocal inhibition of flexors. Further research is recommended to explore this hypothesis.

REDEFINING THE CAUSE AND REHABILITATION OF SPASTICITY AFTER STROKE: INSIGHT FROM USE OF OPTOKINETIC CHART STIMULATION