Abstract
Optimizing the treatment of disabling spasticity in persons with spinal cord damage
is hampered by a lack of consensus regarding the use of acceptable definitions of
spasticity and disabling spasticity, and the relative absence of decision tools such
as clinical guidelines and concise algorithms to support decision-making within the
broader clinical community. Many people with spinal cord damage are managed outside
specialist centers, and variations in practice result in unequal access to best practice
despite equal need. In order to address these issues, the Ability Network—an international
panel of clinical experts—was initiated to develop management algorithms to guide
and standardize the assessment, treatment, and evaluation of outcomes of persons with
spinal cord damage and disabling spasticity. To achieve this, consensus was sought
on common definitions through facilitated, in-person meetings. To guide patient selection,
an in-depth review of the available tools was performed and expert consensus sought
to develop an appropriate instrument. Literature reviews are guiding the selection
and development of tools to evaluate treatment outcomes (body functions, activity,
participation, quality of life) as perceived by people with spinal cord damage and
disabling spasticity, and their caregivers and clinicians. Using this approach, the
Ability Network aims to facilitate treatment decisions that take into account the
following: the impact of disabling spasticity on health status, patient preferences,
treatment goals, tolerance for adverse events, and in cases of totally dependent persons,
caregiver burden.
Keywords
List of abbreviations:
ICF (International Classification of Functioning, Disability and Health), ITB (intrathecal baclofen), QOL (quality of life)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 06, 2016
Footnotes
Supported by Medtronic, Inc, which provided sponsorship and logistical support in the form of meeting services, project coordination, manuscript preparation, and literature reviews.
Disclosures: P.E. has a financial relationship with Allergan and Ipsen, outside the submitted work. The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
