Someplace in here our stroke leaders should be able to use this to help the 30% of survivors that have spasticity. But nothing will occur since our stroke leaders have their heads buried so far up their asses they can't see any way to use research that is out there might be able to solve any of the Problems in stroke.
Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol
Abstract
Introduction
Spasticity is one of the primary pathologies associated with cerebral
palsy (CP), yet no definitive evidence exists to guide the appropriate
level of spasticity management for an individual. Spasticity management
strategies often differ by center. On one end of this strategy spectrum
is a highly-interventional approach, characterized by treatments such as
a selective dorsal rhizotomy (SDR), intrathecal baclofen pump (ITB),
and anti-spasticity injections and medications. On the other end of the
spectrum is a less interventional approach, involving minimal use of
these treatments, and no SDR.
Methods and analysis
A retrospectively-matched, multi-center study protocol is described
that comprehensively compares the long-term outcomes of a
highly-interventional versus a minimally-interventional spasticity
management strategy. We will analyze two groups of adults with spastic
bilateral CP (≥21 years). In one group are individuals who underwent an
SDR between the ages of 4 and 10 years, along with ongoing spasticity
management during childhood and adolescence. In the other group are
individuals who received minimal spasticity management and did not
undergo an SDR. Individuals with prolonged use of an intrathecal
baclofen (ITB) pump will be excluded. The two groups will be matched for
spasticity and other important clinical characteristics at baseline.
This study design improves on many of the limitations found in the
existing outcome literature.
Ethics and dissemination
This study received necessary approval from the University of Minnesota
and Western Institutional Review Boards. Results will be disseminated
via peer-reviewed publications and conference presentations.
Trial registration number
NCT03789786.
This
is an open access article distributed in accordance with the Creative
Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits
others to distribute, remix, adapt, build upon this work
non-commercially, and license their derivative works on different terms,
provided the original work is properly cited, appropriate credit is
given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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