AAPM&R Launches a Multi-Year Initiative to Address Gaps in Spasticity Management and Patient Care

Spasticity is a common challenge for many conditions that the specialty of physical medicine and rehabilitation (PM&R) treats with diverse functional impacts and health disparities. Our member data suggests more than 50% of PM&R physicians have the expertise and position to treat individuals with spasticity. PM&R physicians are often leaders in spasticity assessment and treatment as part of the rehabilitation care team.

AAPM&R recognizes spasticity as a large opportunity for alignment between the specialty and our organization.

AAPM&R has long been involved in this area as PM&R has firmly established its value in treating individuals with spasticity. AAPM&R has engaged in:

• Educational activities
• Convened a task force
• Has relationships with industry with interventions in this space
• Developing clinical guidance

Background

In December 2022, we held the first-ever AAPM&R Spasticity Summit, convening a select group of twenty-nine medical professionals, disability advocates, government officials, researchers, industry representatives and insurers, all working together to discuss the barriers and potential solutions for improved care and support for spasticity patients.

In advance of the Summit, attendees were surveyed about their perception of the importance of key issues to be discussed during the Summit. Based on their responses, "State of Spasticity in U.S. Adults: An Evidence-Based Synopsis" was provided to all attendees and used to guide their discussion.

In an expert discussion led by Christina Kwasnica, MD, FAAPMR and Atul Patel, MD, MHSA, FAAPMR, perspectives and insights on specific barriers to treatment for spasticity patients and solutions to those barriers were exchanged.

Barriers Identified for Spasticity Management 

• There is a need to document the inequality of access to care driven by geography and clinician shortage.
• Education of patients and caregivers and their partnership is essential to improve care for spasticity patients.
• There is a need to increase the number of providers with the expertise to provide the care needed by individuals with spasticity.
• It is vital that the standard of care is articulated; when the best practice is defined, the multidisciplinary team can identify and mitigate gaps in care to better serve patients.
• There is a significant need to complete research and gather data to provide proof of the depth of the problems to justify the improvement of care.

Solutions to Address Barriers

• Access to Care
  • Increase the number of providers that treat spasticity.
  • Reduce overall patient healthcare costs with appropriate spasticity treatment.
  • Improve reimbursement for spasticity management.
  • Improve practice efficiency for spasticity management.
• Patient and Caregiver Support
  • Enhance patient and caregiver education.
  • Establish a "home base" or spasticity coalition website.
• Clinical Capacity and Capabilities
  • Develop and publish consensus guidance statements.
  • Improve workflow for the community of care.
  • Create an evidence-generation data plan for consensus.

Consensus Guidance Statements

One major outcome of AAPM&R’s 2022 Spasticity Summit was a multidisciplinary collaborative consensus statement on the barriers and solutions to care access, patient and caregiver support, and clinical capacity and capability for patients with spasticity.

A new guidance statement was published on May 21, 2024 in the PM&R Journal - "AAPM&R Consensus Guidance on Spasticity Assessment and Management." This guidance establishes a framework that reviews treatment options, endorses the highest quality of evidence-based care and encourages research where there are knowledge gaps.

How to Get Involved

•  AAPM&R members can join our Spasticity Member Community on phyzforum. aapmr.org. 
• Support the ongoing initiatives. Contact corporatesupport@aapmr.org.