Treatment of lower limb spasticity in adults using a multimodal intervention: A mixed-methods approach evaluating the impact across all domains of the ICF




Kim, Jasmine Min Jung

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Spasticity is highly prevalent in neurological conditions involving upper motor neuron lesions (UMNL). Lower limb spasticity is known to impair gait and limit participation in physical activity. Multimodal interventions including botulinum toxin A, orthoses, and physiotherapy have shown longer lasting improvements compared to unimodal interventions. Studies to date, however, have not examined the long term efficacy of this multimodal intervention nor have they examined the impact across a breadth of domains necessary to comprehensively and fully understand its impact. The aim of this study was to investigate the efficacy of a multimodal intervention to treat lower limb spasticity in adults using a longitudinal mixed-methods approach, including a comprehensive set of outcome measures spanning the domains of the International Classification of Functioning, Disability and Health (ICF) model. Seven-teen participants with chronic UMNL were included in the analysis as per inclusion criteria and showed improvements at 6 and 12 months, compared to baseline, within all domains of the ICF model.



spasticity, treatment, adults, chronic, multimodal intervention, mixed-methods, ICF model, bracing, physiotherapy, botulinum toxin, rehabilitation, neurologic impairment, upper motor neuron lesion, stroke, MS, CP, TBI, SCI