Abstract
The recognition, evaluation, and management of disabling spasticity in persons with
spinal cord damage (SCD) is a challenge for health care professionals, institutions,
health systems, and patients. To guide the assessment and management of disabling
spasticity in individuals with SCD, the Ability Network, an international panel of
clinical experts, developed a clinical care pathway. The aim of this pathway is to
facilitate treatment decisions that take into account the effect of disabling spasticity
on health status, individual preferences and treatment goals, tolerance for adverse
events, and burden on caregivers. The pathway emphasizes a patient-centered, individualized
approach and the need for interdisciplinary coordination of care, patient involvement
in goal setting, and the use of assessment and outcome measures that lend themselves
to practical application in the clinic. The clinical care pathway is intended for
use by health care professionals who provide care for persons with SCD and disabling
spasticity in various settings. Barriers to optimal spasticity management in these
people are also discussed. There is an urgent need for the clinical community to clarify
and overcome barriers (knowledge-based, organizational, health system) to optimizing
the management of spasticity in people with SCD.
Keywords
List of abbreviations:
HRQOL (health-related quality of life), ITB (intrathecal baclofen), SCATS (Spinal Cord Assessment Tool for Spastic Reflexes), SCD (spinal cord damage), SCIM (Spinal Cord Independence Measure), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 08, 2018
Footnotes
Presented as a poster to the 55th ISCOS Annual Scientific Meeting, September 14–16, 2016, Vienna, Austria.
Supported by the Ability Network by Medtronic, which provides sponsorship and logistical support in the form of meeting services, project coordination, manuscript preparation, and literature reviews. Scientific direction, work, and dissemination activity was determined independently by the authors and other participating members of the Ability Network.
Disclosures: P. New receives personal fees from Medtronic (outside the submitted work). G. Bilsky receives nonfinancial support from Medtronic (during the conduct of the study) and serves on the speakers bureau of Medtronic (outside the submitted work). D. Bensmail receives grants and personal fees from Medtronic, Allergan, Ipsen, and Merz (outside the submitted work). M. Yochelson receives nonfinancial support from Medtronic (during the conduct of the study) as well as grants, personal fees, and nonfinancial support from Medtronic (outside the submitted work). The other authors have nothing to disclose.
Identification
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© 2017 by the American Congress of Rehabilitation Medicine
