TY - JOUR
T1 - AAPM&R consensus guidance on spasticity assessment and management
AU - Verduzco-Gutierrez, Monica
AU - Raghavan, Preeti
AU - Pruente, Jessica
AU - Moon, Daniel
AU - List, Cassandra M.
AU - Hornyak, Joseph Edward
AU - Gul, Fatma
AU - Deshpande, Supreet
AU - Biffl, Susan
AU - Al Lawati, Zainab
AU - Alfaro, Abraham
N1 - Publisher Copyright:
© 2024 American Academy of Physical Medicine and Rehabilitation.
PY - 2024/8
Y1 - 2024/8
N2 - Background: The American Academy of Physical Medicine and Rehabilitation (AAPM&R) conducted a comprehensive review in 2021 to identify opportunities for enhancing the care of adult and pediatric patients with spasticity. A technical expert panel (TEP) was convened to develop consensus-based practice recommendations aimed at addressing gaps in spasticity care. Objective: To develop consensus-based practice recommendations to identify and address gaps in spasticity care. Methods: The Spasticity TEP engaged in a 16-month virtual meeting process, focusing on formulating search terms, refining research questions, and conducting a structured evidence review. Evidence quality was assessed by the AAPM&R Evidence, Quality and Performance Committee (EQPC), and a modified Delphi process was employed to achieve consensus on recommendation statements and evidence grading. The Strength of Recommendation Taxonomy (SORT) guided the rating of individual studies and the strength of recommendations. Results: The TEP approved five recommendations for spasticity management and five best practices for assessment and management, with one recommendation unable to be graded due to evidence limitations. Best practices were defined as widely accepted components of care, while recommendations required structured evidence reviews and grading. The consensus guidance statement represents current best practices and evidence-based treatment options, intended for use by PM&R physicians caring for patients with spasticity. Conclusion: This consensus guidance provides clinicians with practical recommendations for spasticity assessment and management based on the best available evidence and expert opinion. Clinical judgment should be exercised, and recommendations tailored to individual patient needs, preferences, and risk profiles. The accompanying table summarizes the best practice recommendations for spasticity assessment and management, reflecting principles with little controversy in care delivery.
AB - Background: The American Academy of Physical Medicine and Rehabilitation (AAPM&R) conducted a comprehensive review in 2021 to identify opportunities for enhancing the care of adult and pediatric patients with spasticity. A technical expert panel (TEP) was convened to develop consensus-based practice recommendations aimed at addressing gaps in spasticity care. Objective: To develop consensus-based practice recommendations to identify and address gaps in spasticity care. Methods: The Spasticity TEP engaged in a 16-month virtual meeting process, focusing on formulating search terms, refining research questions, and conducting a structured evidence review. Evidence quality was assessed by the AAPM&R Evidence, Quality and Performance Committee (EQPC), and a modified Delphi process was employed to achieve consensus on recommendation statements and evidence grading. The Strength of Recommendation Taxonomy (SORT) guided the rating of individual studies and the strength of recommendations. Results: The TEP approved five recommendations for spasticity management and five best practices for assessment and management, with one recommendation unable to be graded due to evidence limitations. Best practices were defined as widely accepted components of care, while recommendations required structured evidence reviews and grading. The consensus guidance statement represents current best practices and evidence-based treatment options, intended for use by PM&R physicians caring for patients with spasticity. Conclusion: This consensus guidance provides clinicians with practical recommendations for spasticity assessment and management based on the best available evidence and expert opinion. Clinical judgment should be exercised, and recommendations tailored to individual patient needs, preferences, and risk profiles. The accompanying table summarizes the best practice recommendations for spasticity assessment and management, reflecting principles with little controversy in care delivery.
UR - http://www.scopus.com/inward/record.url?scp=85193751972&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85193751972&partnerID=8YFLogxK
U2 - 10.1002/pmrj.13211
DO - 10.1002/pmrj.13211
M3 - Article
C2 - 38770827
AN - SCOPUS:85193751972
SN - 1934-1482
VL - 16
SP - 864
EP - 887
JO - PM and R
JF - PM and R
IS - 8
ER -