Educational Materials: Compendium

Dear Participant Letter

  • Welcome from our Chairman Dr. Simpson

Program Overview

  • Details of the Program

Slide Library

  • Summary of NeuroRehab Preceptor Program Learning Objectives
  • Overview of spasticity, including pathophysiology and spastic paresis development
  • Clinical assessment of muscle overactivity in upper motor neuron syndrome
  • Treatment options for spasticity and muscle overactivity, including injectable medication

Differential Diagnosis for Spasticity

  • Overview of causes
  • Possible upper limb symptoms to observe and evaluate, including
    • Clenched fist; thumb-in-palm deformity; flexed wrist; flexed elbow; pronated forearm; functionally limited arm after stroke; adducted, internally rotated, flexion-restricted shoulder; intrinsic plus hand
  • Possible lower limb symptoms to observe and evaluate, including
    • Equinovarus foot, flexed hip, nonflexing hip, adducted thigh, adducted hip, stiff knee, flexed knee, valgus foot, hyperextended big toe
  • Assessment tools
    • Upper limb measures, including
      • Modified Ashworth Scale, Barthel Index, modified Frenchay Scale
    • Lower limb measures, including
      • Gait analysis

Patient Qualification and Selection

  • Comprehensive summary to assist in patient evaluation and treatment selection
  • Checklist to be filled out and submitted for each patient selected to participate in the NeuroRehab Clinical Consult Program

Therapeutic Options

  • Overview of pharmacotherapies for spasticity and muscle overactivity
    • Oral medications, including
      • Muscle relaxants, anxiolytics/benzodiazepines,
        α2-adrenergic agonists, and anticonvulsants
    • Chemodenervation
    • Physical therapy
    • Occupational therapy
    • Surgery

Botulinum Toxin Labeling Statement

  • Review of FDA Request for Class Labeling for Botulinum Toxin Treatments

Suggested Reading and Resources

  • List of suggested articles and other resources to obtain additional information about spasticity, muscle overactivity, and current treatments