A physician has prescribed oral baclofen for a patient with T2 AIS A SCI whose severe spasticity has not responded to physical therapy interventions alone. Which is the MOST appropriate role of the physical therapist?

A physician has prescribed oral baclofen for a patient with T2 AIS A SCI whose severe spasticity has not responded to physical therapy interventions alone. Which is the MOST appropriate role of the physical therapist?

• A. Discontinue all physical therapy interventions since the medication will fully manage spasticity
• B. Continue standing programs, stretching, and splinting as adjuncts to the pharmacological management
• C. Recommend the physician discontinue the medication immediately and rely solely on physical therapy
• D. Prescribe a higher dose of baclofen independently

Answer: (B)

Managing spasticity after a spinal cord injury involves combining pharmacologic treatment with ongoing rehabilitation. Baclofen can reduce muscle tone, but it does not automatically restore movement or prevent shortening of muscles and joints. The physical therapist remains essential to maintain range of motion, prevent contractures, and support functional positioning and standing, which can also benefit cardiovascular health and bone density. Therefore, continuing standing programs, stretching, and splinting as adjuncts to the medication is the best approach. These PT activities complement the drug, helping to preserve flexibility and alignment while the pharmacologic agent reduces spasticity. Increasing the baclofen dose or discontinuing PT would require physician oversight and may introduce risks or functional decline. Relying solely on therapy without medication would likely leave spasticity inadequately controlled.

Managing spasticity after a spinal cord injury involves combining pharmacologic treatment with ongoing rehabilitation. Baclofen can reduce muscle tone, but it does not automatically restore movement or prevent shortening of muscles and joints. The physical therapist remains essential to maintain range of motion, prevent contractures, and support functional positioning and standing, which can also benefit cardiovascular health and bone density.

Therefore, continuing standing programs, stretching, and splinting as adjuncts to the medication is the best approach. These PT activities complement the drug, helping to preserve flexibility and alignment while the pharmacologic agent reduces spasticity. Increasing the baclofen dose or discontinuing PT would require physician oversight and may introduce risks or functional decline. Relying solely on therapy without medication would likely leave spasticity inadequately controlled.