Northern Colorado Rehabilitation Hospital, Johnstown, CO, Australia.
Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Epworth-Monash Rehabilitation Medicine Unit, Southern Medical School, Monash University, Clayton, Victoria, Australia; Rehabilitation and Aged Care Service, Kingston Centre, Monash Health, Cheltenham, VIC, Australia.
Arch Phys Med Rehabil. 2018 Aug;99(8):1681-1687. doi: 10.1016/j.apmr.2018.01.017. Epub 2018 Feb 8.
The recognition, evaluation, and management of disabling spasticity in persons with spinal cord damage (SCD) is a challenge for health care professionals, institutions, health systems, and patients. To guide the assessment and management of disabling spasticity in individuals with SCD, the Ability Network, an international panel of clinical experts, developed a clinical care pathway. The aim of this pathway is to facilitate treatment decisions that take into account the effect of disabling spasticity on health status, individual preferences and treatment goals, tolerance for adverse events, and burden on caregivers. The pathway emphasizes a patient-centered, individualized approach and the need for interdisciplinary coordination of care, patient involvement in goal setting, and the use of assessment and outcome measures that lend themselves to practical application in the clinic. The clinical care pathway is intended for use by health care professionals who provide care for persons with SCD and disabling spasticity in various settings. Barriers to optimal spasticity management in these people are also discussed. There is an urgent need for the clinical community to clarify and overcome barriers (knowledge-based, organizational, health system) to optimizing the management of spasticity in people with SCD.
脊髓损伤（SCD）患者致残性痉挛的识别、评估和管理对医疗保健专业人员、机构、卫生系统和患者都是一个挑战。为了指导 SCD 患者致残性痉挛的评估和管理，能力网络（Ability Network），一个国际临床专家小组，制定了一个临床护理路径。该路径的目的是促进治疗决策，这些决策要考虑到致残性痉挛对健康状况、个体偏好和治疗目标的影响、对不良事件的耐受性以及对照顾者的负担。该路径强调以患者为中心、个体化的方法，需要跨学科协调护理，患者参与目标设定，以及使用评估和结果测量方法，这些方法在临床实践中具有实际应用价值。该临床护理路径供在各种环境中为 SCD 患者提供护理的医疗保健专业人员使用。还讨论了这些人最佳痉挛管理的障碍。临床界迫切需要澄清和克服障碍（知识基础、组织、卫生系统），以优化 SCD 患者的痉挛管理。
