Optimizing the Diagnosis and Management of Spasticity

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Target AudienceThis initiative is intended for physiatrists, neurologists, and other healthcare professionals involved in the care of patients…


Target AudienceThis initiative is intended for physiatrists, neurologists, and other healthcare professionals involved in the care of patients with spasticity post-stroke, post-traumatic brain injury, and in children with cerebral palsy (CP).Program OverviewChildren with CP may present with a variety of functional problems and gait disorders due to various impairments including muscle overactivity, loss of selective motor control, and disturbances in sensation. In order to set appropriate goals for treatment, it is imperative to distinguish among various forms of muscle overactivity and assess their impact on function and quality of life. This archived live symposium will provide participants with the opportunity to optimize the diagnosis and management of patients with muscle overactivity, evaluate the potential benefits and risks of an array of treatment options, including oral medications, chemodenervation (ie, toxins, phenol), intrathecal baclofen, selective dorsal rhizotomy, and orthopedic surgery. In addition, new data and remaining challenges resulting from recent clinical trials will be addressed. Case presentations will be used to discuss the process of goal setting and treatment selection with attention to the role of botulinum toxin – alone and in combination with other treatment modalities – throughout patients’ lifespans.GoalTo provide clinicians involved in the care of children with CP with the most up-to-date clinical knowledge and strategies for the optimal diagnosis and management of patients with CP-related spasticity.Learning ObjectivesUpon completion of this activity, the participant should be able to:RECOGNIZE and discriminate the various forms of muscle overactivity including spasticity, dystonia, and related disorders in children with CP and discuss the advantages of appropriate treatment.ASSESS the efficacy and safety data on available pharmacotherapy for spasticity in children with CP.EVALUATE the use of botulinum toxin injections as part of individualized treatment plans for managing spasticity in children with CP.Credit AvailablePhysicians — maximum of 2.5 AMA PRA Category 1 Credits™All other healthcare professionals completing this course will be issued a statement of participation.FacultyKatharine E. Alter, MD (Course Director)Pediatric/Adult PhysiatristMount Washington Pediatric HospitalClinical Assistant Professor, Pediatrics, Physical Medicine RehabilitationAT Still UniversityMesa, ArizonaEdward R. Dabrowski, MDSystem DirectorPediatric Physical Medicine and RehabilitationBeaumont Children’s HospitalRoyal Oak, MichiganMauricio R. Delgado, MD, FAAN, FRCPCProfessor of NeurologyUniversity of Texas Southwestern Medical CenterDirector of Pediatric Neurology and NeurorehabilitationTexas Scottish Rite Hospital for ChildrenDallas, TexasMark Gormley, Jr, MDPediatric Rehabilitation Medicine PhysicianSection ChiefPediatric Physical Medicine and RehabilitationGillette Children’s Specialty HealthcareSaint Paul, MinnesotaPhysician Continuing Medical EducationAccreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Dannemiller and ASiM. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians.Credit DesignationDannemiller designates this enduring material for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Disclosures of Conflicts of InterestIn accordance with the Accreditation Council for Continuing Medical Education (ACCME), Dannemiller requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest.The following faculty member has stated that she has no financial relationships with commercial interests: Katherine E. Alter, MDThe following faculty members have financial relationships with commercial interests:Dr Dabrowski reports serving as a site PI for Ipsen, for the current UE abobotulinumtoxinA trial, and for the Allergan LE onabotulinumtoxinA trial; serving as a global PI for the Merz XARA trial; serving on the advisory board for Ipsen; and serving as a consultant and on a speakers’ bureau for US Medical (Solstice).Dr Delgado reports serving as an investigator for Ipsen Biopharmaceuticals.Dr Gormley reports serving as an investigator for Allergan Inc and Ipsen Biopharmaceuticals.Bernard Abrams, MD, Content Reviewer; Jennifer Hodge, Dannemiller Project Manager; Lou Settembrino, Vice President, ASiM; Mary Camillo, Director, Department of Fulfillment Services, ASiM; Cathy Zehr, Director, Logistical Services, ASiM; and, Lisa Mangione, Senior Editor, Department of Fulfillment Services, ASiM have no financial relationships with commercial interests.To resolve identified/potential conflicts of interest, the educational content was fully reviewed by a member of the Dannemiller Clinical Content Review Committee who has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence based and commercially balanced.Method of ParticipationParticipants should first read the objectives and other introductory CME information and then proceed to the educational activity. To receive credit for this activity, participants should log into the activity, complete the preassessment, review and complete the enduring web-based activity, and complete the postassessment and evaluation in order to receive credit. Credit is provided through December 16, 2017. No credit will be given after this date. There is no fee to participate in this activity.This program consists of video and slides synced with voiceover audio along with interactive questions.In the event you have questions about this activity or are unable to retrieve the certificate, please e-mail cme@dannemiller.com and a certificate will be emailed within 2 weeks.TECHNICAL QUESTIONS – Please contact ASiM at 908-253-9001 or webmaster@asimcme.com.Instructions for Participation and CreditThis program consists of archived presentations, enhanced by slides, case vignettes, and question and answer periods. This enduring material will provide a complete review and study of current treatment and management practices for pediatric patients with spasticity.Hardware and Software RequirementsPentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, Sound card and speakers, Adobe Acrobat Reader.Disclosure of Unlabeled UseThis educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.DisclaimerThe content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Dannemiller, ASiM, and Ipsen Biopharmaceuticals, Inc. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.Table of ContentsPreassessmentOverview and Activity GoalsKatherine E. Alter, MDReview of Spasticity and Other Movement DisordersKatharine E. Alter, MDReview of CP-Related Gait Disorders in ChildrenMark Gormley, Jr, MDPatient Evaluation and Goal SettingMauricio R. Delgado, MD, FAAN, FRCPC 

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