A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction
BackgroundSpasticity is a known complication to the hemiplegic shoulder following acquired brain injury. However, there is a current discrepancy between the diagnosis of arm spasticity and the subsequent assessment and treatment of spasticity in people with shoulder involvement.ObjectiveAn expert pa...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1440955/full |
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| author | Damon Hoad Stephen Ashford Stephen Ashford Ganesh Bavikatte Rachel Farrell Rachel Farrell Adrian Robertson Jörg Wissel Jörg Wissel |
| author_facet | Damon Hoad Stephen Ashford Stephen Ashford Ganesh Bavikatte Rachel Farrell Rachel Farrell Adrian Robertson Jörg Wissel Jörg Wissel |
| author_sort | Damon Hoad |
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| description | BackgroundSpasticity is a known complication to the hemiplegic shoulder following acquired brain injury. However, there is a current discrepancy between the diagnosis of arm spasticity and the subsequent assessment and treatment of spasticity in people with shoulder involvement.ObjectiveAn expert panel aimed to establish a consensus and provide a simple structured approach to identifying and assessing people with spasticity of the hemiplegic shoulder.MethodsA consensus group of six spasticity experts were interviewed individually via 1-h video calls to ascertain how they assess people with arm spasticity for shoulder involvement. During an in-person meeting in March 2023, a consensus-building process was used to discuss four topics: a checklist/tool to identify shoulder involvement in upper limb spasticity, measurements/scales for assessing shoulder spasticity, ‘red flags’ for other conditions affecting the shoulder, and assessment limitations and practicalities.ResultsWhere there was full agreement on a topic, recommendations to overcome challenges for initial and ongoing assessment of shoulder spasticity and goal-setting were developed, and categorized as Posture, Purposeful activity and Pain (‘the three Ps’). Posture should be observed when sitting and walking, as appropriate for the person, and compared to published shoulder spasticity patterns. Purposeful activity should be assessed using a systematic approach. The presence and nature of shoulder pain should be ascertained. Recommendations on impairment- and function-related measures are given.ConclusionThis consensus guidance provides practical recommendations on identifying shoulder spasticity to support clinicians in their management of people with neurological shoulder dysfunction. |
| format | Article |
| id | doaj-art-f56568f41ffb42809a8c794207bea315 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-f56568f41ffb42809a8c794207bea3152025-01-23T14:28:45ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.14409551440955A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunctionDamon Hoad0Stephen Ashford1Stephen Ashford2Ganesh Bavikatte3Rachel Farrell4Rachel Farrell5Adrian Robertson6Jörg Wissel7Jörg Wissel8Warwick Medical School, University of Warwick, Coventry, United KingdomDepartment of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United KingdomLondon North West University Healthcare NHS Trust, Regional Hyper-Acute Rehabilitation Unit, Northwick Park Hospital, London, United KingdomNeuro-Rehabilitation Medicine, The Walton Centre NHS Foundation Trust, Liverpool, United KingdomQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United KingdomDepartment of Rehabilitation, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, United KingdomMid Yorkshire Hospitals Teaching Trust, Wakefield, United KingdomNeurology and Psychosomatic at Wittenbergplatz, Berlin, GermanyUniversity of Potsdam, Potsdam, Brandenburg, GermanyBackgroundSpasticity is a known complication to the hemiplegic shoulder following acquired brain injury. However, there is a current discrepancy between the diagnosis of arm spasticity and the subsequent assessment and treatment of spasticity in people with shoulder involvement.ObjectiveAn expert panel aimed to establish a consensus and provide a simple structured approach to identifying and assessing people with spasticity of the hemiplegic shoulder.MethodsA consensus group of six spasticity experts were interviewed individually via 1-h video calls to ascertain how they assess people with arm spasticity for shoulder involvement. During an in-person meeting in March 2023, a consensus-building process was used to discuss four topics: a checklist/tool to identify shoulder involvement in upper limb spasticity, measurements/scales for assessing shoulder spasticity, ‘red flags’ for other conditions affecting the shoulder, and assessment limitations and practicalities.ResultsWhere there was full agreement on a topic, recommendations to overcome challenges for initial and ongoing assessment of shoulder spasticity and goal-setting were developed, and categorized as Posture, Purposeful activity and Pain (‘the three Ps’). Posture should be observed when sitting and walking, as appropriate for the person, and compared to published shoulder spasticity patterns. Purposeful activity should be assessed using a systematic approach. The presence and nature of shoulder pain should be ascertained. Recommendations on impairment- and function-related measures are given.ConclusionThis consensus guidance provides practical recommendations on identifying shoulder spasticity to support clinicians in their management of people with neurological shoulder dysfunction.https://www.frontiersin.org/articles/10.3389/fneur.2024.1440955/fullmuscle spasticityshoulderarmclinical decision-makinggoal setting |
| spellingShingle | Damon Hoad Stephen Ashford Stephen Ashford Ganesh Bavikatte Rachel Farrell Rachel Farrell Adrian Robertson Jörg Wissel Jörg Wissel A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction Frontiers in Neurology muscle spasticity shoulder arm clinical decision-making goal setting |
| title | A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction |
| title_full | A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction |
| title_fullStr | A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction |
| title_full_unstemmed | A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction |
| title_short | A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction |
| title_sort | concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction |
| topic | muscle spasticity shoulder arm clinical decision-making goal setting |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1440955/full |
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