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AAPM&R consensus guidance on spasticity assessment and management. | LitMetric

AI Article Synopsis

  • The AAPM&R conducted a comprehensive review in 2021 to improve care for patients with spasticity, leading to the formation of a technical expert panel (TEP) for developing practice recommendations.
  • Over 16 months, the TEP employed a structured evidence review process, utilizing a modified Delphi method for consensus on evidence-based recommendations and grading.
  • The TEP approved five management recommendations and established best practices, aimed at guiding PM&R physicians in treating spasticity while emphasizing the need to tailor care to individual patient circumstances.

Article Abstract

Background: The American Academy of Physical Medicine and Rehabilitation (AAPM&R) conducted a comprehensive review in 2021 to identify opportunities for enhancing the care of adult and pediatric patients with spasticity. A technical expert panel (TEP) was convened to develop consensus-based practice recommendations aimed at addressing gaps in spasticity care.

Objective: To develop consensus-based practice recommendations to identify and address gaps in spasticity care.

Methods: The Spasticity TEP engaged in a 16-month virtual meeting process, focusing on formulating search terms, refining research questions, and conducting a structured evidence review. Evidence quality was assessed by the AAPM&R Evidence, Quality and Performance Committee (EQPC), and a modified Delphi process was employed to achieve consensus on recommendation statements and evidence grading. The Strength of Recommendation Taxonomy (SORT) guided the rating of individual studies and the strength of recommendations.

Results: The TEP approved five recommendations for spasticity management and five best practices for assessment and management, with one recommendation unable to be graded due to evidence limitations. Best practices were defined as widely accepted components of care, while recommendations required structured evidence reviews and grading. The consensus guidance statement represents current best practices and evidence-based treatment options, intended for use by PM&R physicians caring for patients with spasticity.

Conclusion: This consensus guidance provides clinicians with practical recommendations for spasticity assessment and management based on the best available evidence and expert opinion. Clinical judgment should be exercised, and recommendations tailored to individual patient needs, preferences, and risk profiles. The accompanying table summarizes the best practice recommendations for spasticity assessment and management, reflecting principles with little controversy in care delivery.

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Source
http://dx.doi.org/10.1002/pmrj.13211DOI Listing

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