OUTCOME MEASURES IN SPASTICITY MANAGEMENT

Development of validated and reliable outcome measures for spasticity rehabilitation has been hampered by the difficulty of quantifying func tionally important parameters such as pain, ease of care, and mobility Nonetheless, a combination of measures designed to assess technical a nd functional outcomes, patient satisfaction, and the cost effectivene ss of treatment can be used together to evaluate status and track chan ge in spasticity management, including treatment programs involving bo tulinum toxin. While double-blind, placebo-controlled studies remain t he gold standard for clinical testing, the single-subject design is a useful alternative in many treatment protocols. Because no single tool can measure the many types of changes possible with treatment, the ch oice of assessment tools must be based on the functional changes expec ted from the treatment. A wide range of assessment tools are criticall y reviewed for their sensitivity reliability, validity, and ease of ad ministration. (C) 1997 John Wiley & Sons, Inc.