**8. Conclusion**

In general, four professionals have roles in a spasticity clinic team including a physician (a pediatric or adult neurologist or a physical medicine and rehabilitation specialist), nurse, occupational therapist, and physiotherapist [2]. In the following,

• Understanding the underlying condition, prognosis, natural history, associated features, and possible complications. Identifying the abnormal features or

• Being experienced in neuromuscular history-taking and physical examination.

• Being able to perform necessary interventions including administering oral medications, botulinum toxin injection, intrathecal drug, and splint.

unexpected changes that may be caused by a secondary cause.

*Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice*

• Educating the patient and his/her caregivers to manage spasticity.

ensuring that they follow the protocols and guidelines properly.

• Managing psychosocial issues and considering the impact of spasticity on employment and social activities of the patient and managing it.

• Monitoring the patient's and caregiver's adaptations with the treatments and

• Identifying the potential for movement patterns and functional ability to be

• Identifying trigger factors of spasticity related to posture and movement.

• Assessing the patient for posture and siting especially in a wheelchair.

• Evaluating the patient's access to work, home, and community environments.

Permanent presences of other specialists in the team are not necessarily needed, but they can be helpful in the treatment process. These specialists include orthopedics, neurosurgeons, speech therapists, orthotists, social workers, continence advi-

One of the valuable points in setting up such services is their growth and development to provide better services. This goal is achieved through data

• Assessing the impact of spasticity on the patient's performance.

• Advising the patient on posture, moving, and handling.

• Identifying muscle weakness underlying the spasticity.

• Assessing the patient for proper use of splints.

the tasks of each professional are briefly discussed.

• Managing cutaneous and visceral triggers.

Physician:

Nurse:

Physiotherapist:

improved.

Occupational therapist:

sors, and psychologists.

**104**

Spasticity is one of the common symptoms in a wide range of neurological conditions and it needs a multidisciplinary approach for best management. This chapter provided an excellent paradigm to incorporate many of the key elements that are fundamental, including: assessment of the individual with spasticity, provision of education and promoting self-management, physical management of spasticity (physiotherapy or occupational therapy), orthoses, pharmacological intervention, and setting up a service.
