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
Inaugural Spasticity Summit
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 Statement
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.
Next Steps/Goals
The following four goals were identified to address the barriers to spasticity care and management.
- Raise awareness about this issue
- Address and improve access to care
- Demonstrate with evidence the impact of treating patients with spasticity
- Address and improve patient and caregiver support
Our work continues in this space, with AAPM&R asserting a leadership role to address the needs of the known and unknown spasticity population. To learn more, email info@aapmr.org.