Consensus Guidelines for Spasticity Assessment and Management: Monica Verduzco-Gutierrez, MD

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The professor and chair of rehabilitation medicine at UT Health San Antonio talked about the newly published guidelines for the assessment and management of spasticity in patients with neurological conditions. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"It’s important to assess how spasticity is impacting [the patients’] muscles, quality of life, and function. Reassessing what their goals are and treating them based on how spasticity is impacting them."

Among clinicians in physical medicine and rehabilitation, spasticity is a common disorder observed among patients particularly for those with neurological disorders. The condition has several etiologies of brain and spinal origin across all ages, being a component of the upper motor neuron syndrome.1 Research shows that spasticity can negatively impact a patient’s function, interfere with their positioning, cause pain and discomfort, and increase burden in caregivers. It is also observed in studies that spasticity can enable improvement in functions such as gait and positioning and assist with transfers.2

In 2021, the American Academy of Physical Medicine and Rehabilitation performed a comprehensive review to identify opportunities to improve the care of adult and pediatric patients with spasticity. An expert panel comprised of lead author Monica Verduzco-Gutierrez, MD, and colleagues, then convened to develop consensus-based practice recommendations to address gaps in spasticity care. Newly published in the PM&R Journal, the panel approved 5 recommendations for spasticity management and 5 best practices for assessment and management, with 1 recommendation unable to be graded because of evidence limitations.3

Following the news of the publication, Verduzco-Gutierrez, professor and chair of rehabilitation medicine at UT Health San Antonio, recently sat down with NeurologyLive® in an interview to discussthe main components of the new consensus guidelines for spasticity management. She also talked about how guidelines highlight the importance of addressing health equity and enhancing access to care for patients with spasticity. Furthermore, Verduzco-Gutierrez spoke about the recommended approach for the long-term management and reassessment of spasticity in patients with neurological disorders.

REFERENCES
1. Chang E, Ghosh N, Yanni D, Lee S, Alexandru D, Mozaffar T. A Review of Spasticity Treatments: Pharmacological and Interventional Approaches. Crit Rev Phys Rehabil Med. 2013;25(1-2):11-22. doi:10.1615/CritRevPhysRehabilMed.2013007945
2. Gormley ME Jr, Krach LE, Piccini L. Spasticity management in the child with spastic quadriplegia. Eur J Neurol. 2001;8 Suppl 5:127-135. doi:10.1046/j.1468-1331.2001.00045.x
3. Verduzco-Gutierrez M, Raghavan P, Pruente J, et al. AAPM&R consensus guidance on spasticity assessment and management. PM R. Published online May 21, 2024. doi:10.1002/pmrj.13211
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