To identify a set of clinically useful outcome measures for assessment of adults receiving treatment for spasticity.
A modified Delphi process was conducted. In round 1, key areas of spasticity assessment and associated outcome measures were identified. In round 2, participants were presented with reviews of eligible outcome measures and were asked to select the tool they believed to be the “best” in each area. Consensus was achieved if there was at least 70% agreement among participants. In round 3, participants rated measures based on feasibility, ability to capture change, and usefulness of information gained for areas where consensus was not achieved in round 2.
The Modified Delphi process was conducted online using survey software.
Clinicians (N=32) from centers across Canada participated in this study.
Main Outcome Measures
Of 51 tools identified initially, 8 were selected. Tools related to body structure and function included the visual analog scale, manual muscle testing, Penn Spasm Frequency Scale, and goniometry. Activity level measures included the Berg Balance Scale, Goal Attainment Scaling (GAS), and the FIM. The Modified Caregiver Strain Index was selected for the assessment of caregiver burden, while GAS was selected for participation level outcomes.
A standardized set of outcome measures will assist with better documentation and standardization of assessment practices of clinicians who manage spasticity.
List of abbreviations:AS (Ashworth Scale), BBS (Berg Balance Scale), GAS (Goal Attainment Scaling), ICF (International Classification of Functioning, Disability and Health), MAS (Modified Ashworth Scale), PSFS (Penn Spasm Frequency Scale), VAS (visual analog scale)
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Published online: October 17, 2014
Supported by Allergan, Inc, and the Department of Physical Medicine and Rehabilitation, St. Joseph’s Health Care London, Ontario.
Disclosures: R.T. reports grants from Allergan, Inc, during the conduct of the study. T.M. reports grants and personal fees (honoraria) from Allergan, Inc, during the conduct of the study. The other authors have nothing to disclose.
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.