A comprehensive person-centered approach to adult spastic paresis: a consensus-based framework
| Autor: | Simão Serrano, Alberto Esquenazi, Lynne Turner-Stokes, Stephen Ashford, Jörg Wissel, Michael P. Barnes, Jorge Lains, Anthony B. Ward, Ian J. Baguley, David M. Simpson, Gerard E. Francisco, Areerat Suputtitada |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Consensus SMART criteria medicine.medical_treatment Psychological intervention Physical Therapy Sports Therapy and Rehabilitation Person-centered therapy Risk Assessment Severity of Illness Index Goal Attainment Scaling 03 medical and health sciences Disability Evaluation 0302 clinical medicine Physical medicine and rehabilitation Patient-Centered Care Self-management medicine Humans Spasticity Disease management (health) Botulinum Toxins Type A Goal setting Rehabilitation business.industry Disease Management Prognosis Combined Modality Therapy Exercise Therapy Treatment Outcome Spastic paraparesis Paraparesis Spastic Practice Guidelines as Topic Female Muscle spasticity medicine.symptom 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | European journal of physical and rehabilitation medicine. 54(4) |
| ISSN: | 1973-9095 |
| Popis: | Spastic paresis is a common feature of an upper motor neuron impairment caused by stroke, brain injury, multiple sclerosis and other central nervous system (CNS) disorders. Existing national and international guidelines for the treatment of adult spastic paresis tend to focus on the treatment of muscle overactivity rather than the comprehensive approach to care, which may require life-long management. Person-centered care is increasingly adopted by healthcare systems in a shift of focus from "disease-oriented" towards "person-centered" medicine. The challenge is to apply this principle to the complex management of spastic paresis and to include an educative process that engages care providers and patients and encourages them to participate actively in the long-term management of their own disease. To address this issue, a group of 13 international clinicians and researchers used a pragmatic top-down methodology to evaluate the evidence and to formulate and grade the strength of recommendations for applying the principles of person-centered care to the management of spastic paresis. There is a distinct lack of clinical trial evidence regarding the application of person-centered medicine to the rehabilitation setting. However, the current evidence base supports the need to ensure that treatment interventions for spastic paresis should be centered on as far as reasonable on the patient's own priorities for treatment. Goal setting, negotiation and formal recording of agreed SMART goals should be an integral part of all spasticity management programs, and goal attainment scaling should be recorded alongside other standardized measures in the evaluation of outcome. When planning interventions for spastic paresis, the team should consider the patient and their family's capacity for self-rehabilitation, as well as ways to enhance this approach. Finally, the proposed intervention and treatment goals should consider the impact of any neuropsychological, cognitive and behavioral deficits on rehabilitation. These recommendations support a person-centric focus in the management of spastic paresis. |
| Databáze: | OpenAIRE |
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