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Monograph: Spasticity evaluation and management tools
Monograph: Spasticity evaluation and management tools
Abstract
Spasticity is a complex and often disabling symptom for patients with upper motor neuron syndromes. Although spasticity arises from neurological disease, it often cascades into muscle and soft tissue changes, which may exacerbate symptoms and further hamper function. Effective management therefore hinges on early recognition and treatment. To this end, the definition of spasticity has expanded over time to more accurately reflect the spectrum of symptoms experienced by persons with this disorder. Once identified, clinical and research quantitative assessments of spasticity are hindered by the uniqueness of presentations both for individuals and for specific neurological diagnoses. Objective measures in isolation often fail to reflect the complex functional impact of spasticity. Multiple tools exist to quantitatively or qualitatively assess the severity of spasticity, including clinician and patient-reported measures as well as electrodiagnostic, mechanical, and ultrasound measures. A combination of objective and patient-reported outcomes is likely required to better reflect the burden of spasticity symptoms in an individual.
Therapeutic options exist for the treatment of spasticity along a broad spectrum from nonpharmacologic to interventional procedures. Treatment strategies may include exercise, physical agent modalities, oral medications, injections, pumps, and surgery. Optimal spasticity management most often requires a multimodal approach, combining pharmacological management with interventions that match the functional needs, goals, and preferences of the patient. Physicians and other healthcare providers who manage spasticity must be familiarized with the full array of spasticity interventions and must frequently reassess results of treatment to ensure the patient's goals of treatment are met.

Objectives: 
1) Understand and be able to evaluate the various causes of spasticity
2) Be able to apply various clinician-administered outcome measures in the assessment of
patients with spasticity
3) Appropriately choose and utilize nonpharmacologic and pharmacologic measures for
management of spasticity


ACCREDITATION STATEMENT

The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

DISCLOSURE INFORMATION
Ileana Howard has no conflicts of interest to disclose. Atul Patel reports grants for clinical trials and consultancy with Allergan/AbbVie, IPSEN, and Revance; speaker fees for Allergan/AbbVie and Ipsen. Any conflicts of interest have been resolved according to ACCME standards. All other authors/planners had no relevant financial relationships to disclose.

CREDIT DESIGNATION
The AANEM designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 3/1/2026.
Author
Ileana M. Howard, MD; Atul T. Patel, MD
Summary
Availability: On-Demand
Expires on Mar 01, 2026
Cost: Member: $0.00
Non-Member: $15.00
Credit Offered:
2 CME Credits
2 CEU Credits


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