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A Simple Bedside Screening Tool for Spasticity Referral.

Mallory L Hacker^1,2, Shelby Ploucher^1,3, Aaditi G Naik^1,4

¹Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.

Clinical Interventions in Aging

|June 12, 2020

Summary

This summary is machine-generated.

A simple bedside tool effectively identifies spasticity in long-term care residents, aiding primary care providers in referring patients for specialist evaluation and treatment.

Keywords:

long-term care neurological disease primary care screening spasticity

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Area of Science:

Neurology
Geriatrics
Primary Care

Background:

Spasticity is a common yet underdiagnosed condition in long-term care facilities.
Underdiagnosis leads to untreated spasticity, causing significant disability for residents.

Purpose of the Study:

To evaluate a three-question flowchart for bedside spasticity screening by primary care providers.
To determine the tool's accuracy in identifying residents needing specialist consultation for spasticity.

Main Methods:

A cross-sectional, observational study was conducted in a long-term care facility.
Primary care providers (PCP and NP) used a flowchart to assess residents for spasticity.
Referral decisions were compared against specialist neurologist evaluations (reference standard).

Main Results:

The study included 49 residents (80% male, mean age 78.2 years).
The flowchart showed high sensitivity (92%) and moderate specificity (78%) when used by a PCP (AUC=0.84).
The tool demonstrated 80% sensitivity and 53% specificity with an NP (AUC=0.67).

Conclusions:

The bedside screening tool shows promise for primary care providers in long-term care settings.
It can assist in identifying residents requiring specialist spasticity evaluation and treatment.
Further research is recommended to validate the tool across diverse settings and providers.