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Satellite Symposium Proceedings Movement Disorders
Conclusion There is growing acceptance that the needs of patients with spasticity
are best addressed by taking a comprehensive approach to their
management – i.e. one that encompasses the patient’s physical needs
and mental wellbeing, beginning at the first assessment and continuing
through the various stages of the rehabilitation process. The use of GAS
1. Houlden H, Charlton P, Singh D, Neurology and orthopaedics, J
Neurol Neurosurg Psychiatry, 2007;78:224–32.
2. Turner-Stokes L, Fheodoroff K, Jacinto J, et al., Upper limb
international spasticity study: rationale and protocol for a
large, international, multicentre prospective cohort study
investigating management and goal attainment following
treatment with botulinum toxin A in real-life clinical practice,
BMJ Open, 2013;3:e002230.
3. Becker G, Kaufman SR, Managing an uncertain illness
trajectory in old age: patients’ and physicians’ views of stroke,
Med Anthropol Q, 1995;9:165–87.
4. Pound P, Bury M, Gompertz P, et al., Views of survivors
of stroke on benefits of physiotherapy, Qual Health Care,
1994;3:69–74. 5. Turner-Stokes L, Goal attainment scaling (GAS) in
rehabilitation: a practical guide, Clin Rehabil, 2009;23:362–70.
6. Turner-Stokes L, Baguley IJ, De Graaff S, et al., Goal attainment
scaling in the evaluation of treatment of upper limb spasticity
with botulinum toxin: a secondary analysis from a double-
blind placebo-controlled randomized clinical trial, J Rehabil
7. Doan QV, Brashear A, Gillard PJ, et al., Relationship between
disability and health-related quality of life and caregiver
burden in patients with upper limb poststroke spasticity, PMR,
2012;4:4–10. 8. Sturm JW, Donnan GA, Dewey HM, et al., Quality of life after
stroke. The North East Melbourne Stroke Incidence Study
(NEMESIS), Stroke, 2004;35:2340–5.
9. Kiresuk TJ, Sherman RE, Goal attainment scaling: A general
method for evaluating comprehensive community mental
health programs, Community Ment Health J, 1968;4:443–53.
10. Wade DT, Goal setting in rehabilitation: an overview of what,
why and how, Clin Rehab, 2009;23:291–5.
11. McCrory P, Turner-Stokes L, Baguley IJ, et al., Botulinum toxin
A for treatment of upper limb spasticity Following stroke:
a multi-centre randomized placebo-controlled Study of the
effects on quality of life and other person-centred outcomes,
J Rehabil Med, 2009;41:536–44.
12. Turner-Stokes L, Vanderstay R, Stevermuer T, et al.,
Comparison of rehabilitation outcomes for long term
neurological conditions: a cohort analysis of the Australian
rehabilitation outcomes centre dataset for adults of working
age, PLoS One, 2015;10:e0132275.
13. Barnes M, Fheodoroff K, Kocer S, et al., Information and
40 can engage and motivate patients to play a full part alongside their
care teams. Appropriate clinical assessment scales provide meaningful
information for the physician in regards to the complete treatment
plan, including BoNT-A and a rehabilitation program. Guided self-
rehabilitation might help to achieve the best possible outcomes. ■
treatment gaps in the management of spasticity: Results from
an international survey. Presented at: IneReM, Istanbul, Turkey,
4–6 June 2015.
14. Turner-Stokes L, Fheodoroff K, Jacinto J, et al., Results from
the Upper Limb International Spasticity Study-II (ULISII): a
large, international, prospective cohort study investigating
practice and goal attainment following treatment with
botulinum toxin A in real-life clinical management, BMJ Open,
2013;3:e002771. 15. Scobbie L, Dixon D, Wyke S, Goal setting and action planning
in the rehabilitation setting: development of a theoretically
informed practice framework, Clin Rehabil, 2011;25:468–82.
16. Fheodoroff K, Ashford S, Jacinto J, et al., Factors influencing
goal attainment in patients with post-stroke upper limb
spasticity following treatment with botulinum toxin a in real-
life clinical practice: sub-analyses from the Upper
Limb International Spasticity (ULIS)-II study, Toxins,
2015;7:1192–205. 17. Ashford S, Turner-Stokes L, Upper Limb Spasticity Index.
Available at: http://scale-library.com (accessed 11 January
2015). 18. Bakheit AM, Zakine B, Maisonobe P, et al.,The profile
of patients and current practice of treatment of upper
limb muscle spasticity with botulinum toxin type A: an
international survey, Int J Rehabil Res, 2010;33:199–204.
19. Bohannon RW, Smith MB, Assessment of strength deficits
in eight paretic upper extremity muscle groups of stroke
patients with hemiplegia, Phys Ther, 1987;67:522–5.
20. Tardieu G, Rondont O, Mensch J, et al., Responses
electromyographiques a l’etirement musculaire chez
l’homme normal, Rev Neurol, 1957;97:60–1.
21. Gracies JM, Bayle N, Vinti M, et al., Five step clinical
assessment in spastic paresis, Eur J Phys Rehabil Med,
2010;46:411–21. 22. Sunnerhagen KS, Olver J, Francisco GE, Assessing and treating
functional impairment in poststroke spasticity, Neurology,
2013;80(3 Suppl. 2):S35–544.
23. Patrick E, Ada L. The Tardieu Scale differentiates contracture
from spasticity whereas the Ashworth Scale is confounded by
it, Clin Rehabil, 2006;20:173–82.
24. Gracies JM, Marosszeky JE, Renton R, et al., Short-term effects
of dynamic Lycra splints on upper limb in hemiplegic patients,
Arch Phys Med Rehabil, 2000;81:1547–55.
25. Ashford S, Turner-Stokes L, Goal attainment for spasticity
management using botulinum toxin, Physiother Res Int,
2006;11:24–34. 26. Gracies JM, Brashear A, McAllister P, et al., Randomized,
double-blind placebo-controlled Phase III study of Dysport,
AbobotulinumtoxinA, in the treatment of adults with upper
limb spasticity. Poster 404, ISPRM 2014.
27. Gracies JM, Khatkova S, Skoromets A, et al., Spastic
movement disorder treated by AbobotulinumtoxinA (Dysport)
in the hemiparetic upper limb: a randomized, double-blind,
placebo-controlled, Phase III study. Abstract MDS 2014
LBA125. 28. Skilbeck CE, Wade DT, Hewer RL, et al., Recovery after stroke,
J Neurol Neurosurg Psychiatry, 1983;46:5–8.
29. Moore JL, Roth EJ, Killian C, et al., Locomotor training improves
daily stepping activity and gait efficiency in individuals
poststroke who have reached a “plateau” in recovery, Stroke,
2010;41:129–135. 30. Gracies JM, Pathophysiology of spastic paresis. Part I. Paresis
and soft tissue contracture, Muscle Nerve 2005;31:535–55.
31. Gracies JM, Pathophysiology of spastic paresis. Part II.
The emergence of muscle overactivity. Muscle Nerve
2005;31:552–571. 32. Gracies JM, Coefficients of impairment in deforming spastic
paresis, Ann Phys Rehab Med, 2015;58:173–178.
33. Cordo P, Lutsep H, Cordo L, et al., Assisted movement with
enhanced sensation (AMES): coupling motor and sensory
to remediate motor deficits in chronic stroke patients,
Neurorehabil Neural Repair, 2009;23:67–77.
34. Cauraugh JH, Lodha N, Naik SK, et al., Bilateral movement
training and stroke motor recovery progress: a structured
review and meta-analysis, Hum Mov Sci, 2010;29:853–870.
35. Ada L, Goddard E, McCully J, et al., Thirty minutes of
positioning reduces the development of shoulder external
rotation contracture after stroke: a randomized controlled
trial, Arch Phys Med Rehabil, 2005;86:230-234.
36. Gracies JM, Blondel R, Gault-Colas C, et al., Contrat
d’Autorééducation Guidée dans la parésie spastique.
De Boeck edition, ©Association Neurorééducation en
Mouvement, Paris 2013;108.
37. Gracies JM, Alkandari S, Nicolas Bayle N, et al., Effects of self-
rehabilitation contracts combined with repeated botulinum
toxin injections on walking speed in chronic hemiparesis.
A prospective open-label study. Poster Presentation 0231
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