Definition, Assessment and Treatment of Spasticity According to Physiotherapists and Occupational Therapists in Flanders, Belgium: A Cross-sectional Qualitative Study.

NCT06956534 | Completed FDA Device

• 1 other identifier: 6901
• Study Type: observational
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

The definition of spasticity described by Lance in 1980 provided a strong academic foundation for characterizing this neurological symptom. However, there are doubts about its value in clinical practice for evaluating and treating spasticity. This "upper motor neuron syndrome" is highly complex and does not exist in isolation. Beyond the various definitions that have been attributed to it, spasticity correlates with sensory input, movement, muscle properties, and the continuity of the central nervous system. This has led to an ongoing academic debate regarding how spasticity should be classified and how it should be treated correctly. This study aims to improve quality by gaining a better understanding of how healthcare providers (physiotherapists \& occupational therapists) perceive the definition, evaluation, and treatment of spasticity. The questionnaire is based on the existing study by Blanchette et al. (2017), which was conducted in Canada and surveyed both English- and French-speaking physiotherapists and occupational therapists. That study examined sociodemographic data, work environment, satisfaction with measurement tools for spasticity, and treatment preferences. This study adopts these components while adding an extra item: the definition of spasticity. The research team included this item to explore how healthcare providers interpret spasticity. This will be assessed through multiple-choice and open-ended questions. The research will be conducted under the supervision of Prof. Dr. Steven Truijen (Universiteitsplein 1, 2610 Wilrijk, Belgium, steven.truijen@uantwerpen.be) and Prof. Dr. Wim Saeys (Universiteitsplein 1, 2610 Wilrijk, Belgium, wim.saeys@uantwerpen.be), organized by the University of Antwerp. During this study, no costs or reimbursements will be expected from participants, health insurance, or the research environment.

Conditions

Spasticity

Keywords

spasticity; questionnaire; occupational therapy; physiotherapy

Outcome Measures

Primary Outcomes (4)

• Demographics of professional (Occupational therapists & Physiotherapists)

  1. Profession * Occupational Therapist * Physiotherapist * Trained in both professions 2. Gender * Male * Female * Unknown 3. Age 4. How many years of experience do you have in clinical practice overall? * Less than 1 year * Approximately 1 to 3 years * Between 4 and 10 years * More than 10 years 5. What percentage of your clientele consists of neurological patients? * None * Less than 30% * 31% - 75% * More than 75% 6. How would you best describe your work environment? (multiple answers possible) * Hospital * Rehabilitation center * Institute * Private practice * Medical-pedagogical institute for children * Mental health institute * School * University * University college * Home care * Other: 7. What is your current field of work? (multiple answers possible) * Neurology * Orthopedics * Pediatrics * Pulmonology * Physical Activity * Sports * Geriatrics * Psychiatry 8. High level of professional education * Master's degree * Bachelor's degree 9. What is your area of specialization?

  Once in questionnaire

• Interpretation and Definition of Spasticity

  10\. How would you describe spasticity? \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 11. Which of the following definitions of spasticity seems most appropriate to you? * \[ \] Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes... * \[ \] A motor disorder due to abnormal intraspinal processing of primary afferent input. * \[ \] Impaired sensorimotor control from an upper motor neuron lesion causing involuntary muscle activation. * \[ \] Involuntary muscle hyperactivity in the presence of central paresis, including various components. * \[ \] A speed- and length-dependent increase in resistance due to hyperexcitable pathways. * \[ \] None of the above

  Once in questionnaire

• Spasticity Assessment

  12\. Which healthcare provider should be responsible for evaluating spasticity? * Physician * Physiotherapist * Occupational Therapist * Nurse * Other: 13\. When should the evaluation/testing take place? * At intake * After 3 weeks * At hospital discharge (returning home) * Periodically * During rehabilitation 14. How important is it to use validated and reliable measurement tools for spasticity? * Very important * Important * Neutral * Unimportant Therapist Questionnaire * Not important at all 15. Which of the following measurement tools do you use to evaluate spasticity? * Range of Motion * Modified Ashworth Scale Deep Tendon Reflexes * Functional Scales * Ashworth Scale * Torque Measurements * Modified Tardieu Scale * Clinical Score of Tone * Spasm Frequency Scale * Composite Spasticity Index * Clonus Scale * Pendulum Test * EMG * Other: 16\. How satisfied are you with the following measurement tools? Range of Motion Clonus Modified Ashworth Scale Deep Tendon Reflex Functional Scal

  Once in questionnaire

• Spasticity Management

  17\. How do you currently treat spasticity? * Long-term stretching * Long-term ice application * Sensory-level stimulation (TENS) * Motor-level stimulation * Vibration * Splinting * Positioning * Traction * Other: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

  Once in questionnaire

Study Arms (1)

caregivers

physiotherapists and occupational therapists

Other: Questionnaire and Physical Exam

Interventions

Questionnaire and Physical Exam OTHER

online digital questionnaire

caregivers

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The included respondent group consisted of Dutch-speaking Belgian adults with a degree in physiotherapy or occupational therapy, who completed the full online questionnaire on spasticity. Respondents who did not meet these criteria or who did not confirm the informed consent, were excluded. Experience in the work field was not a requirement to participate in this study. The researchers chose to only include fully completed questionnaires, even if a partially completed questionnaire had some relevant information to process. This was done to be consistent in the number of responses and the data analysis. It is also not known why a respondent chose to stop without filling out all the questions. In Belgium, occupational therapy is offered as a three-year bachelor's program. Physical therapy, which was originally a three-year bachelor's degree as well, became an academic program of four years in 1998 and was subsequently extended to a five-year master's program in 2002.

You may qualify if:

• Licensed Occupational Therapists or Physiotherapists
• Dutch Speaking
• Working in Flanders

You may not qualify if:

• Questionnaire not completed
• Informed Consent not given

Sponsors & Collaborators

• Universiteit Antwerpen: lead

Study Sites (1)

Department of Rehabilitation sciences and physiotherapy (MOVANT)

Antwerp, Antwerp, 2020, Belgium

Location

MeSH Terms

Conditions

Muscle Spasticity

Interventions

Surveys and Questionnaires; Restraint, Physical

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Muscle Hypertonia; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health; Behavior Control; Therapeutics; Immobilization

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, PhD, MSc

Study Record Dates

• First Submitted: April 24, 2025
• First Posted: May 4, 2025
• Study Start: September 16, 2024
• Primary Completion: February 28, 2025
• Study Completion: February 28, 2025
• Last Updated: May 4, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, CSR
• Time Frame: From publication ( around June 2025) and afterwards 20 years (limit of data storage)
• Access Criteria: University or Academic Institution

Locations

BE (1)