Adherence to focal spasticity guidelines: A systematic review.

Abstract

Focal muscle spasticity is a disabling impairment, affecting as many as twothirds of people with a neurological condition. Level 1 evidence exists for the use of botulinum toxin (BoNT-A) to reduce spasticity, and this is stipulated in twenty-five international management guidelines. However, given that intramuscular BoNT-A does not always translate to improved functional outcomes, the association between other guideline-endorsed aspects of care and patient goal attainment remains unclear in the literature. Adherence to international guideline recommendations for focal spasticity management is low. Stronger guideline adherence, prioritizing recommendation importance or understanding barriers to guideline implementation could help to focus future research towards key areas of spasticity management that have the greatest impact on functional outcomes.