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Mallory L. Hacker; Peter E. Konrad; Thomas L. Davis; David Charles. Author Response: Deep Brain Stimulation in Early-Stage Parkinson Disease: Five-Year Outcomes. Neurology 2021, 96, 592 -592.
AMA StyleMallory L. Hacker, Peter E. Konrad, Thomas L. Davis, David Charles. Author Response: Deep Brain Stimulation in Early-Stage Parkinson Disease: Five-Year Outcomes. Neurology. 2021; 96 (12):592-592.
Chicago/Turabian StyleMallory L. Hacker; Peter E. Konrad; Thomas L. Davis; David Charles. 2021. "Author Response: Deep Brain Stimulation in Early-Stage Parkinson Disease: Five-Year Outcomes." Neurology 96, no. 12: 592-592.
Spasticity is common in long-term care settings (affecting up to one in three residents), yet it remains under-treated despite safe and effective, Food and Drug Administration (FDA)-approved therapies. One barrier to treatment may be lack of awareness of available therapies for long-term care residents living with spasticity. A standardized spasticity treatment awareness and interest interview was conducted with 18 nursing home residents and 11 veterans’ home residents in this cross-sectional study. Veterans’ home residents were also asked about potential barriers to receiving spasticity treatment. Many residents across both long-term care facilities were unaware of most of the treatment options for spasticity. Participants were most aware of physical/occupational therapy (83%, 95% CI: 65–93%) and least aware of intrathecal baclofen (21%, 95% CI: 9–39%). After learning about treatments, only 7% of participants (95% CI: 0–23%) were not interested in receiving any form of spasticity treatment. Among residents previously unaware of spasticity treatments, at least one quarter became interested in receiving treatment and at least one-fifth indicated possibly being interested in the treatment after learning about it. Potential barriers to receiving treatment included traveling to see a doctor and limited knowledge of insurance coverage of spasticity treatments. These results suggest that patient-centered approaches, including education and discerning patient preferences, may improve spasticity treatment in long-term care settings.
Mallory Hacker; Michael Putman; Chandler Gill; Maxim Turchan; Taylor Hudson; Amanda Currie; Fenna Phibbs; David Charles. Long-Term Care Resident Awareness and Interest in Spasticity Treatments. Geriatrics 2021, 6, 21 .
AMA StyleMallory Hacker, Michael Putman, Chandler Gill, Maxim Turchan, Taylor Hudson, Amanda Currie, Fenna Phibbs, David Charles. Long-Term Care Resident Awareness and Interest in Spasticity Treatments. Geriatrics. 2021; 6 (1):21.
Chicago/Turabian StyleMallory Hacker; Michael Putman; Chandler Gill; Maxim Turchan; Taylor Hudson; Amanda Currie; Fenna Phibbs; David Charles. 2021. "Long-Term Care Resident Awareness and Interest in Spasticity Treatments." Geriatrics 6, no. 1: 21.
Blepharospasm and oromandibular dystonia are focal dystonias characterized by involuntary and often patterned, repetitive muscle contractions. There is a long history of medical and surgical therapies, with the current first-line therapy, botulinum neurotoxin (BoNT), becoming standard of care in 1989. This comprehensive review utilized MEDLINE and PubMed and provides an overview of the history of these focal dystonias, BoNT, and the use of toxin to treat them. We present the levels of clinical evidence for each toxin for both, focal dystonias and offer guidance for muscle and site selection as well as dosing.
Travis J.W. Hassell; David Charles. Treatment of Blepharospasm and Oromandibular Dystonia with Botulinum Toxins. Toxins 2020, 12, 269 .
AMA StyleTravis J.W. Hassell, David Charles. Treatment of Blepharospasm and Oromandibular Dystonia with Botulinum Toxins. Toxins. 2020; 12 (4):269.
Chicago/Turabian StyleTravis J.W. Hassell; David Charles. 2020. "Treatment of Blepharospasm and Oromandibular Dystonia with Botulinum Toxins." Toxins 12, no. 4: 269.
To determine the prevalence, rate of underdiagnosis and undertreatment, and association with activities of daily living dependency of spasticity in a nursing home setting. Cross-sectional study. This study is an analysis of a deidentified data set generated by a prior quality improvement project at a 240-bed nursing home for residents receiving long-term care or skilled nursing care services. Each resident was examined by a movement disorders specialist neurologist to determine whether spasticity was present and, if so, the total number of spastic postures present in upper and lower limbs was recorded. Medical records, including the Minimum Data Set, were reviewed for neurologic diagnoses associated with spasticity, activities of daily living (ADL) dependency, and prior documentation of diagnosis and past or current treatments. Ordinary least squares linear regression models were used to evaluate the association between spasticity and ADL dependency. Two hundred nine residents (154 women, 81.9 ± 10.9 years) were included in this analysis. Spasticity was present in 22% (45/209) of residents examined by the neurologist. Only 11% of residents (5/45) had a prior diagnosis of spasticity and were receiving treatment. Presence of spasticity was associated with greater ADL dependency (χ2 = 51.72, P < .001), which was driven by lower limb spasticity (χ2 = 14.56, P = .006). These results suggest that spasticity (1) is common in nursing homes (1 of 5 residents), (2) is often not diagnosed or adequately treated, and (3) is associated with worse ADL dependency. Further research is needed to enhance the rates of diagnosis and treatment of spasticity in long-term care facilities.
Chandler E. Gill; Mallory L. Hacker; Jacqueline Meystedt; Maxim Turchan; John F. Schnelle; Sandra F. Simmons; Ralf Habermann; Fenna T. Phibbs; David Charles. Prevalence of Spasticity in Nursing Home Residents. Journal of the American Medical Directors Association 2020, 21, 1157 -1160.
AMA StyleChandler E. Gill, Mallory L. Hacker, Jacqueline Meystedt, Maxim Turchan, John F. Schnelle, Sandra F. Simmons, Ralf Habermann, Fenna T. Phibbs, David Charles. Prevalence of Spasticity in Nursing Home Residents. Journal of the American Medical Directors Association. 2020; 21 (8):1157-1160.
Chicago/Turabian StyleChandler E. Gill; Mallory L. Hacker; Jacqueline Meystedt; Maxim Turchan; John F. Schnelle; Sandra F. Simmons; Ralf Habermann; Fenna T. Phibbs; David Charles. 2020. "Prevalence of Spasticity in Nursing Home Residents." Journal of the American Medical Directors Association 21, no. 8: 1157-1160.