Comprehensive Care of Patients with Spastic Paresis – A Long-Term Commitment

Spastic paresis is a frequent complication of lesions to central motor pathways. Patients who develop spasticity require specialised rehabilitation programmes to alleviate their symptoms, help them to relearn motor skills and regain some independence. Long-term management of patients with spastic paresis requires a comprehensive approach that addresses the patient’s physical needs and mental wellbeing, and continues throughout all stages of the rehabilitation process. There are three pillars of success for long-term rehabilitation programmes in spastic paresis. Since most human behaviour is goal-directed, the first is to employ patient-centred goal setting to engage and motivate patients to play an active part in their own rehabilitation. Goals should be meaningful for and achievable by the patient, and revised as necessary. The second foundation of success is to ensure detailed clinical assessment, using appropriate spasticity assessment scales to inform Botulinum toxin treatment plans -doses and muscles to be injected. Lastly, the use of guided self-rehabilitation programmes encourages an active role for patients in their treatment and maximises outcomes. This paper summarises proceedings from the Comprehensive Care of Patients with Spastic Paresis: A Long-Term Commitment symposium, at the International Society of Physical and Rehabilitation Medicine World Congress, 2015.