Spasticity in adults living in a developmental center.
OBJECTIVE
To ascertain the prevalence of spasticity among adults living in a developmental center and to document the development of spasticity treatment plans for this population.


METHODS
Descriptions of the clinical features of medical disorders and a prevalence survey.


METHODS
Residential developmental center.


METHODS
One hundred three adults.


METHODS
Not applicable.


METHODS
Characteristics described included the prevalence of spasticity in this population, the specific spasticity diagnosis, functional goals for spasticity treatment identified by the participants' multidisciplinary teams, and the specific treatment indicated by the neurologist.


RESULTS
Of the 103 people diagnosed by the neurologist, 24 had diplegic spasticity, 4 had hemiplegic spasticity, 44 had quadriplegic spasticity, and 31 had no spasticity. Functional goals identified by multidisciplinary teams were undergarment change (46.3% of the persons for whom goals were identified), splinting hands (11%), dressing (57.4%), hygiene (20.4%), wheelchair positioning (25.9%), ambulation improvement (14.8%), and transfers (9.3%). After physical and occupational therapy, the first invasive treatments indicated for people with spasticity included botulinum toxin injections (60%), intrathecal baclofen (26.4%), orthopedic surgery (5.6%), and medication (1.4%). No treatment was recommended for 25% of the spasticity patients.


CONCLUSIONS
The prevalence of spasticity was 35% in this developmental center population of 205 individuals. A multidisciplinary team approach to the evaluation of adults with spasticity who live in a developmental center makes it possible to identify functional goals that are amenable to spasticity treatment and minimizes treatment that does not target specific functional goals.
Pfister
Alyssa A
AA
Division of Movement Disorders, Dept. of Neurology, Vanderbilt University Medical Center, 2100 Pierce Avenue, Nashville, TN 37212-3375, USA.
Roberts
Amanda G
AG
Taylor
Henry M
HM
Noel-Spaudling
Shayla
S
Damian
M Myrandele
MM
Charles
P David
PD
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001418:Baclofen / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000453:epidemiology; D015897:Comorbidity; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D007273:Injections, Intramuscular; D007278:Injections, Spinal; D008607:Intellectual Disability / Q000453:epidemiology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D009465:Neuromuscular Agents / Q000627:therapeutic use; D015995:Prevalence; D011782:Quadriplegia / Q000150:complications; D012112:Residential Facilities; D013714:Tennessee / Q000453:epidemiology
D009125:Muscle Relaxants, Central; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; D001418:Baclofen