Investigating Influences on the Current Trends in Occupational and Physical Therapy Management of Clients Experiencing Spasticity

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MacKenzie, Diane E.
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Mount Saint Vincent University
Clinicians face a diverse array of therapeutic intervention choices while enabling individuals experiencing spasticity in connection with the upper motor neuron syndrome. Currently, it is not known the extent to which particular therapeutic intervention choices are selected by clinicians while enabling the individual, particularly in light of changing medical management for spasticity. Further, given the relative scarcity of relevant research evidence and other literature to guide clinicians in their treatment decisions in this area, it is unclear what factors serve to influence clinicians’ treatment decision. This thesis reports results from an extensive mail-out survey of Canadian and American occupational and physical therapists working in neurorehabilitation which was designed and conducted with the aims of illuminating current practice trends, and of inferring if/how individual factors influence the clinician's decision making with regards to spasticity management. Nine hundred Canadian and American occupational and physical therapists who self-identified as working in the area of adult neurorehabilitation were randomly selected for a mail survey, and 494 responses were received and analyzed. The survey gathered information about the individual therapist, therapist education, client demographics, practice environments, and the intervention choices for enabling clients experiencing spasticity. Based on these survey results, this thesis provides a description of the choices clinicians are selecting for spasticity-management with clients in terms of the range of current intervention techniques, the relative frequency of use, and the factors (client and therapist related) that may be influencing these choices. The results of this survey will hopefully provide a clearer picture of the clinical decisions currently being made throughout the continent, and how various client and therapist related factors affect these decisions, and thereby assist in the future development of best-practice guidelines for the therapeutic management of spasticity.
Therapeutic Management of Spasticity , Occupational and Physical Therapists , Neurorehabilitation , Therapeutic intervention