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Multi-modal treatment

In this article, the Toxnet group aims to clarify the differences between ‘adjunctive’ and ‘multimodal’ therapy as they are erroneously often used interchangeably which could prevent attainment of treatment goals in spasticity management. Addition of a secondary pharmacologic or non-pharmacologic treatment to optimize the efficacy of the initial modality, is considered an adjunctive therapy. Multimodal therapy is an integrated, patient-centric program of pharmacologic and non pharmacologic strategies utilized in a concurrent/integrated or sequential manner to enhance the overall treatment effect across a variety of spasticity associated impairments. This paper provides a brief evidence-based review of each approach, and insights on selecting multimodal and adjunctive therapies in spasticity management.

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Supported by Merz Therapeutics GmbH

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Award scoring criteria

The following criteria will be judged out of a score of 5; (1 is suboptimal; 2 is adequate; 3 is good; 4 is very good; 5 is excellent)

GENERAL

  • Days per week working in spasticity management
  • Average number of spasticity patients managed per month
  • Environment and clinical team (type of institution, location, size/structure of clinical team, particular patient needs)
  • Role of responsibility in managing patients with spasticity
  • Scientific appointments in spasticity
  • Honours for work undertaken in spasticity

SCHOLARLY

  • Number of research projects investigating relevant aspects of spasticity management
  • Impact of research projects investigating relevant aspects of spasticity management
  • Number of peer-reviewed publications on topic
    Number of presentations of research at international meetings
  • Number of presentations at national conferences
  • Teaching/mentorship of younger injectors
  • h-index

CLINICAL

  • Evidence of development or growth of a spasticity program at the applicant’s practice or institution
  • Breadth of services provided, including medications, toxins, physical interventions, and Intrathecal Baclofen Therapy (ITB)
  • Role of responsibility in managing patients with spasticity

ENDORSEMENT

  • Endorsed by senior peer

In the event of a tie, based on the above scoring criteria, the Toxnet Co-Chairs will make the final decision.