AAPM&R consensus guidance on spasticity assessment and management

Area of Science:

• Physical Medicine and Rehabilitation
• Neurology
• Clinical Practice Guidelines

Background:

• The American Academy of Physical Medicine and Rehabilitation (AAPM&R) identified a need to enhance spasticity care for adult and pediatric patients.
• A Technical Expert Panel (TEP) was formed to address identified gaps in current spasticity management.
• The TEP aimed to create consensus-based practice recommendations for improved patient care.

Purpose of the Study:

• To develop evidence-based practice recommendations for spasticity assessment and management.
• To identify and address critical gaps in the care of patients with spasticity.
• To provide clinicians with updated guidance for optimal spasticity treatment.

Main Methods:

• A 16-month virtual TEP process involved formulating search terms and refining research questions.
• A structured evidence review was conducted, with evidence quality assessed by the AAPM&R Evidence, Quality and Performance Committee (EQPC).
• A modified Delphi process and the Strength of Recommendation Taxonomy (SORT) were used to achieve consensus and grade recommendations.

Main Results:

• Five recommendations for spasticity management and five best practices for assessment and management were approved.
• One recommendation could not be graded due to insufficient evidence.
• The guidance reflects current best practices and evidence-based treatment options for PM&R physicians.

Conclusions:

• The consensus guidance offers practical, evidence-based recommendations for spasticity assessment and management.
• Clinicians are advised to exercise clinical judgment and tailor recommendations to individual patient needs.
• The recommendations summarize widely accepted principles in spasticity care delivery.