Chronic Spasticity Care.

Chronic spasticity is a dynamic, multifactorial condition that demands continuous, personalized management. This article reviews the evolving pathophysiology of spasticity, emphasizing the interplay of neural hyperexcitability and structural muscle changes. Botulinum toxin type A remains a key intervention but achieves optimal outcomes only when integrated into a multidisciplinary rehabilitation framework. Evidence supports a multimodal approach and the use of adjunct therapies such as stretching, strengthening, orthoses, and task-specific training. Technological advances and goal-oriented tools further enhance long-term care. A paradigm shift is needed: from episodic treatment to chronic disease management focused on function, prevention, and quality of life.