Non pharmacological interventions for spasticity in multiple sclerosis

Amatya, Bhasker; Khan, Fary; Mantia, L. La; Demetrios, Marina; Wade, Derick T

doi:10.1002/14651858.cd009974.pub2

Cited by 75 publications

(34 citation statements)

References 57 publications

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“…10 An evaluation of the scientific evidence regarding physical therapy is beyond the scope of this review and detailed information can be found elsewhere. 11 We aimed to (i) review the current literature involving pharmacological treatment of spasticity, (ii) offer advice on best use of available agents based on the evidence and the consensus of the expert authors and (iii) identify methological limitations in the available evidence.…”

mentioning

confidence: 99%

Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper

et al. 2016

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confidence: 99%

Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper

et al. 2016

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“…Secondly, the relationship between research evidence and usage is a bit more complicated and controversial, with the ambiguity surrounding the evidence being cited by some as a reason why the usage of EPA has been decreasing over the past few decades2 ) . However, this argument ignores the fact that there are now more randomized controlled trials and systematic reviews that have demonstrated treatment effectiveness for patients with a variety of medical conditions such as urinary incontinence34 ) , neck35 ) and knee pain36 ) , muscle weakness37 ) , and spasticity38 ) , among others, which seems to be in direct contradiction to its decreased availability and usage. Thirdly, the association between the other external factors (clinical guidelines, textbooks, workplace protocols, equipment demonstration) and usage may not be as important, since these factors were ranked among the lowest four out of the eight factors.…”

Section: Discussionmentioning

confidence: 99%

Availability, usage, and factors affecting usage of electrophysical agents by physical therapists: a regional cross-sectional survey

2016

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[Purpose] The aim of this study was to investigate the availability, usage, and factors affecting usage of electrophysical agents by physical therapists in Nagano Prefecture, Japan. [Subjects and Methods] Questionnaires were sent to all 1,571 physical therapists working in 245 institutions within Nagano Prefecture. A total of 1,110 questionnaires were returned, out of which 1,099 (70%) questionnaires containing valid responses were analyzed. Frequencies and percentages were calculated for 22 modalities with regards to availability, usage, rate of usage, and confidence level in usage. Factors affecting usage and the relationship between rate of usage and confidence level (Spearman’s rho) were also determined. [Results] The top three responses for the various outcome measures were as follows: (1) hot packs (88%), low frequency stimulators (76%), and ultrasound (68%) for availability; (2) hot packs (72%), ultrasound (61%), and cold packs (59%) for usage; (3) hot packs (75%), cold spray (49%), and ultrasound (44%) for confidence in usage; and (4) equipment availability (80%), past experience (79%), and research evidence (78%) for factors affecting usage. There was a significant positive relationship between confidence and usage for all modalities, except for ultraviolet radiation, iontophoresis, and magnetic field. [Conclusion] Usage was strongly correlated with confidence, with the top three used modalities also being the ones with the highest confidence in usage.

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“…These different treatment options are discussed in more detail in the guidelines in Table 2 and in other review papers. 32,[43][44][45] Financial and administrative barriers …”

Section: Treatment Optionsmentioning

confidence: 99%

Spastic Paresis and Rehabilitation – The Patient Journey

Bowers¹,

Fheodoroff²,

Khan³

et al. 2016

European Neurological Review

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S pastic paresis is a complex condition associated with damage to the upper motor neurons, typically caused by cerebral palsy, multiple sclerosis, stroke or trauma. Despite substantial impact on patients' independence and burden on caregivers, there is a lack of consensus on optimal management of this condition and the patient journey remains unclear. A group of physicians, experienced in spasticity management, recently convened with the objective of analysing the patient journey from a care pathway perspective in different geographical regions and under different conditions from acute phase to long-term/chronic disease status. The experts reviewed results from recent patient and healthcare practitioner surveys on the subject and assessed how current patient pathways could be improved, using their own experiences to highlight the issues related to management deficiencies in their individual countries. The group divided the patient journey into steps, considering the evidence from the point of view of healthcare practitioners, patients, caregivers and funders/payors. This paper is a response to the lack of consensus on the optimal management of spastic paresis, and acts as a call to action to develop a consistent care pathway that could be applied across a broad range of illnesses, using an interdisciplinary approach. KeywordsSpastic paresis, patient rehabilitation, patient journey, patient care, care pathway Disclosure: David Bowers has participated in an advisory board for Ipsen and has been a trainer for Allergan and Medtronic. Klemens Fheodoroff has received unrestricted research grants from Ipsen and Merz, and honoraria for instructional courses from Ipsen, Allergan and Merz. Patricia Khan has participated in advisory boards for Ipsen, and has received honoraria for instructional courses from Ipsen and Allergan. Julian P Harriss has received research funding into current practice in spasticity management (the SPACE study, supported by Merz Pharma) and expenses for participation in expert panels (Ipsen). Khashayar Dashtipour has received compensation/honoraria for services as a consultant or an advisory committee member or speaker from Allergan, Inc., Ipsen Biopharmaceuticals, Inc., Lundbeck Inc., Merz Pharmaceuticals, Teva Pharmaceutical Industries Ltd., UCB Inc., Impax Pharmaceutical and US World Meds. Laxman Bahroo has received personal compensation from Teva Neuroscience, UCB pharma, Impax, Allergan, Ipsen, US World Meds, AbbVie, Lundbeck and Acadia for consulting, serving on a scienti c advisory board or speaking activities, and research support from Ipsen and Teva Neuroscience. Michael Lee has participated in an advisory board for Ipsen. Denis Zakharov has received personal compensation from Ipsen and Merz for consulting, serving on a scienti c advisory board or speaking activities. Jovita Balcaitiene is an employee of Ipsen Pharma. Virgilio Evidente has received research support from Ipsen and honoraria for consulting and/or speaking from Ipsen, Merz, Solstice, US WorldMeds, Lundbeck, UCB, Xenoport, Te...

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Non pharmacological interventions for spasticity in multiple sclerosis

Cited by 75 publications

References 57 publications

Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper

Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper

Availability, usage, and factors affecting usage of electrophysical agents by physical therapists: a regional cross-sectional survey

Spastic Paresis and Rehabilitation – The Patient Journey

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