Disorders affecting the spinal cord and brain can cause loss of upper extremity functioning and independence. This clinic improves hand grasp, pinching ability and elbow movement in patients through advanced surgical, medical and rehabilitation interventions, lessening spasticity and paralysis that are resistant
to standard treatment.
The clinic’s goal is to improve upper extremity functioning of individuals living with spinal cord injuries and other nervous system disorders.
Who We Serve
The clinic provides evaluations and both nonsurgical and surgical options for individuals 5 years old and older with functional limitations affecting the shoulder, elbow, wrist and/or hand due to spasticity and/or paralysis arising from the following conditions:
- Spinal cord injury (traumatic and nontraumatic)
- Stroke
- Multiple sclerosis
- Cerebral palsy
- Other central nervous system disorders
Our Team
We are a fully integrated interdisciplinary team focused on providing a comprehensive approach to evaluating and treating patients with functional limitations arising from spasticity and/or paralysis. Our clinic is a collaborative program between Kennedy Krieger Institute and The Johns Hopkins Hospital that leverages the combined expertise of both organizations to provide the best outcomes for children and adults with this disorder.
Our team includes:
- Physical medicine and rehabilitation physician certified in treating spinal cord injuries
- Plastic surgeon
- Occupational therapists
- Physical therapists
Our Approach
Our goal is to help patients improve functioning and minimize the long-term complications associated with spasticity and paralysis. We conduct an initial comprehensive evaluation and develop a customized treatment and therapy program for each patient. While surgical recommendations are the unique feature of this clinic, conservative treatment options and noninvasive interventions are always considered first and may be deemed as most appropriate. Interventions may include:
- Diagnostic motor point and nerve block injections
- Occupational and physical therapy, including intensive activity-based rehabilitation therapies
- Specialized state-of-the-art equipment and techniques, including robotics
- Noninterventional medical treatment recommendations for spasticity (e.g., oral antispasticity medications, botulinum toxin injections, baclofen pumps, etc.)
- Surgery to regain shoulder, elbow, wrist, finger or thumb functioning by transferring functioning muscles and nerves to paralyzed muscles or reducing the amount of spasticity and tightness in existing muscles. Possible surgeries include:
- Nerve transfers
- Tendon transfers
- Tendon lengthening
- Hyperselective neurectomies
- Postoperative rehabilitation following the latest evidence-based protocols, with occupational or physical therapists working in close collaboration with a patient’s physician and surgeon