Abstract
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Highlights
Spasticity is a common sequela of upper motor neuron conditions that can reduce quality of life, impair function, and heighten economic burden.[1]
The great majority of Canadian spasticity outpatient clinics have been canceled or are predominantly administered through telemedicine, which has led to a dramatic reduction in patient volume
In the scenario where in-person treatment is required, ensure strict protective equipment (PPE) and safety precautions adhering to local guidelines on how COVID-19 positive patients are to be managed
Summary
Spasticity is a common sequela of upper motor neuron conditions that can reduce quality of life, impair function, and heighten economic burden.[1]. We have identified a subset of patients that require inperson assessment and access to treatment modalities such as intrathecal baclofen pump therapy, focal chemodenervation, and orthotic adjustments In this practical guidance paper, we outline a triaging strategy to determine the urgency of managing spasticity patients inperson versus using telemedicine. In the scenario where in-person treatment is required, ensure strict PPE and safety precautions adhering to local guidelines on how COVID-19 positive patients are to be managed. ○ If possible, pre-mix/reconstitute botulinum toxin for immediate use outside of the injection room This process can often be facilitated by preloading syringes with the appropriate amount of saline immediately before the clinic to streamline the reconstitution process once the patient arrives. ○ Advise patients to wear clothing that is removable or accessible to reduce preparation time and potentially avoid the need for the use of an overhead lift to expose targeted regions
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