How Can We Improve Current Practice in Spastic Paresis?

Well shit, you prevent spasticity from happening in the 30% of stroke survivors that get it.
Solve the correct problem, not the side effects of that problem. Almost feel like I'm teaching grade schoolers the basics. 
https://www.linkedin.com/pulse/how-can-we-improve-current-practice-spastic-paresis-jon-shepheard

Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity. The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients’ quality of life, by affecting their ability to perform normal activities. This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services. The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients’ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.
Fheodoroff K., et. al., How Can We Improve Current Practice in Spastic Paresis? European Neurological Review, 2016;11(2):ePub ahead of print
For the open access PDF of the full article please go to the following link to download: http://www.touchneurology.com/articles/how-can-we-improve-current-practice-spastic-paresis
I absolutely despise Figure 3: Community Integration After Stroke.
Because it has adjusting my expectations in the diagram. Never, never, never lower your expectations. Your expectation is that your doctor and therapists will completely cure your spasticity. Nothing less.
My comment to this article:
 Have we finally gotten out from under the influence of Dr. William M. Landau? Spasticity After Stroke: Why Bother.