BoNT-A for Post-Stroke Spasticity: Guidance on Unmet Clinical Needs from a Delphi Panel Approach.
There is extensive literature supporting the efficacy of botulinum toxin (BoNT-A) for the treatment of post-stroke spasticity, however, there remain gaps in the routine management of patients with post-stroke spasticity. A panel of 21 Italian experts was selected to participate in this web-based survey Delphi process to provide guidance that can support clinicians in the decision-making process. There was a broad consensus among physicians that BoNT-A intervention should be administered as soon as the spasticity interferes with the patients' clinical condition. Patients monitoring is needed over time, a follow-up of 4-6 weeks is considered necessary. Furthermore, physicians agreed that treatment should be offered irrespective of the duration of the spasticity. The Delphi consensus also stressed the importance of patient-centered goals in order to satisfy the clinical needs of the patient regardless of time of onset or duration of spasticity. The findings arising from this Delphi process provide insights into the unmet needs in managing post-stroke spasticity from the clinician's perspective and provides guidance for physicians for the utilization of BoNT-A for the treatment of post-stroke spasticity in daily practice.
['Baricich|Alessio|A|0000-0001-8440-6283', 'Wein|Theodore|T|', 'Cinone|Nicoletta|N|0000-0002-5389-3290', 'Bertoni|Michele|M|', 'Picelli|Alessandro|A|0000-0002-3558-8276', 'Chisari|Carmelo|C|', 'Molteni|Franco|F|', 'Santamato|Andrea|A|0000-0002-1452-8485']
D065087:Acetylcholine Release Inhibitors D019274:Botulinum Toxins, Type A D000066491:Clinical Decision-Making D032921:Consensus D003697:Delphi Technique D006801:Humans D009128:Muscle Spasticity D018802:Patient-Centered Care D020521:Stroke D000071939:Stroke Rehabilitation D013997:Time Factors D016896:Treatment Outcome
spasticity Delphi botulinum toxin rehabilitation stroke