Experimental research indicates spasticity occurs in response to stretch of relaxed hemiparetic muscle. In actively contracting muscle of stroke patients, research findings have shown reduced EMG activity and weakness of muscles of both affected and unaffected sides of the body. Additionally, in actively contracting hemiparetic muscle, evidence has revealed non-reflex mediated stiffness which can be attributed in part to changes in connective tissue arising from disuse secondary to hemiparesis. Clinical implications of these scientific findings are presented for the physiotherapy management of cerebrovascular accident. Informed choice and consent for cervical spine manipulation.
Informed consent is essential in ethical health care practice.
Information and advice regarding choices is a precondition of informed consent. Autonomy, truthfulness and ethical decision making are all relevant to the informed choice and consent process. The purpose of this paper is firstly to discuss these topics. Following this, a case of informed choice and consent for cervical spine manipulation is examined. This case illustrates ethical problems that can arise in the informed choice and consent process.