Toning it down: selecting outcome measures for spasticity management using a modified Delphi approach.

Area of Science:

• Rehabilitation Medicine
• Neurology
• Clinical Assessment

Background:

• Spasticity is a common motor disorder affecting adults, often requiring ongoing management.
• Standardized outcome measures are crucial for consistent and effective assessment of spasticity and its impact.

Purpose of the Study:

• To identify a consensus-driven set of clinically useful outcome measures for adults undergoing spasticity treatment.
• To establish a standardized approach to spasticity assessment in clinical practice.

Main Methods:

• A modified Delphi process involving 32 Canadian clinicians was employed.
• Three rounds of online surveys were used to identify and select the best outcome measures.
• Consensus was defined as at least 70% agreement among participants.

Main Results:

• Eight outcome measures were selected from an initial list of 51.
• Selected measures cover body structure/function (e.g., Visual Analog Scale, Penn Spasm Frequency Scale), activity (e.g., Berg Balance Scale, FIM), and caregiver burden (Modified Caregiver Strain Index).
• Goal Attainment Scaling (GAS) was identified for both activity and participation outcomes.

Conclusions:

• The identified set of 8 outcome measures provides a standardized framework for spasticity assessment.
• Standardization of these measures will enhance clinical documentation and improve assessment practices.
• This consensus-based approach ensures the selection of clinically relevant and useful tools for managing spasticity.