A series of exercises may also be suggested for maintenance of tone, strength and range of motion. Dr. de Lateur has been part of a team that designed a machine to quantitatively evaluate spasticity of the lower extremities. For some patients, this may be an important tool to investigate how much spasticity is interfering with function. Most patients with TM have spasticity, while a fair number of patients have pain due to their illness. Both symptoms interfere with recovery and quality of life.
Spasticity often makes it harder to ambulate or to utilize the extremities in a coordinated fashion.
A wide variety of medications are available for these problems, but for patients with TM, medications are occasionally prescribed in inadequate doses, or in suboptimal combinations. Some of these medicines have troubling side effects including fatigue. For some patients who experience these side effects, a novel approach employed at Johns Hopkins may be appropriate. He can then administer medicines directly into this fluid either for pain control or for relief of spasticity. The medicines do not get distributed throughout the body, and so there are fewer side effects from this approach.