Skip to content
DraconiticResearch
Search Sources API
194,164 studies31 sourcesUpdated 39 min ago
Peer-reviewedCC BY 4.0Frontiers in Neurology

Improving detection of candidates for botulinum toxin therapy in spasticity: an interprofessional screening approach

  • Melanie Rudelstorfer1,2
  • Brigitte Mayr-Pirker3,4
  • Eugen Trinka5,6,7,8
  • Bernhard Iglseder3
  • Richard Friedrich Radlberger5
8 affiliations
  1. 1Department for Orthopedics and Traumatology, University Hospital Salzburg, Paracelsus Medical University
  2. 2Nursing Management, University Hospital Salzburg, Paracelsus Medical University
  3. 3Department of Geriatric Medicine, University Hospital Salzburg, Paracelsus Medical University
  4. 4Institute of Palliative Care, Paracelsus Medical University
  5. 5Department of Neurology, Neurological Intensive Care and Neurorehabilitation, Christian Doppler Medical Centre, Paracelsus Medical University
  6. 6Neuroscience Institute, Christian Doppler University Hospital, Centre of Cognitive Neuroscience, Paracelsus Medical University
  7. 7Karl Landsteiner Institute for Clinical Neuroscience
  8. 8Institute of Public Health, Medical Decision-Making and HTA, UMIT - Private University for Health Sciences, Medical Informatics and Technology
Read full textPDFDOICite

Abstract

Background: Spastic movement disorders (SMD) are commonly treated with botulinum toxin, however, many patients who may benefit from treatment remain unrecognized in routine clinical practice. Early identification is particularly challenging in non-specialized settings. This study evaluated the diagnostic performance of interprofessional screening tools for identifying patients with clinically relevant SMD requiring referral for specialist assessment.

Methods: In this prospective, two-phase, single-center study, 124 patients who received care by departments of neurology and geriatrics were included. In phase 1, the Spastic Movement Disorder decision tree (SMD-DT) was applied independently by nurses, physiotherapists, and occupational therapists and compared with the clinical assessment of an experienced neurologist as the reference standard. Based on the findings, a simplified nursing screening tool, the Salzburg Nursing Questionnaire (SNQ), was developed and subsequently evaluated in independent cohorts in phase 2 of the study.

Results: The SMD-DT demonstrated high agreement with the reference standard in neurological rehabilitation settings, with a high degree of consistency across all professional groups compared with the expert, but showed substantially lower performance among nurses in non-specialized geriatric settings. In contrast, the SNQ consistently achieved high diagnostic accuracy in these settings (sensitivity of 1.00 and specificity of 0.96) considering treatment recommendation.

Conclusion: The diagnostic performance of screening instruments for SMD depends strongly on both clinical context and professional background. These findings support the implementation of profession-specific screening strategies to improve early recognition of clinically relevant SMD, facilitating timely referral for specialist evaluation, and optimize access to botulinum toxin therapy in routine clinical practice.

Related

  1. Active Function Improvement with Repeated Injections of Botulinum Toxin A in Upper Limb Spasticity: A Longitudinal Analysis from the ULIS-III Study.
    Stephen A Ashford, Mark Weatherall, Klemens Fheodoroff +4
    ToxinsPeer-reviewedCC BYFull textNeurologyEurope PMC
  2. Botulinum toxin type a within function-oriented management of post-stroke spasticity: a narrative review
    Baoling Su, Yating Huang, Xiaotong Li +2
    Frontiers in NeurologyPeer-reviewedCC BY 4.0Full textNeurologyCrossrefEurope PMC
  3. Adjunctive extracorporeal shock wave therapy after botulinum toxin type A injection for post-stroke spasticity: a systematic review and three-level meta-analysis
    Weihao Ke, Lujiang Wang, Wenli Shen +2
    Frontiers in NeurologyPeer-reviewedCC BY 4.0Full textNeurologyCrossrefEurope PMCPMC
  4. Potential biomarker candidates for improving diagnosis and disease treatment in adenomyosis
    Aitana Merino-Pérez, Ana Belén Albert, María del Mar Mascarell-López +3
    eBioMedicinePeer-reviewedCC BY-NC-ND 4.04 citedObstetrics, gynaecology & paediatricsCrossref
  5. Improving Immediate Postpartum Detection of Obstetric Anal Sphincter Injury: Added Diagnostic Value of Impedance Spectroscopy Following Clinical Assessment
    M. Uchman Musielak, K. Kleczkowska, I. Sudol Szopinska +1
    medRxivPreprintAll rights reservedFull text1 citedObstetrics, gynaecology & paediatricsmedRxiv

Cite

BibTeXRIS
BibTeX
@article{rudelstorfer2026improving,
  title = {{Improving detection of candidates for botulinum toxin therapy in spasticity: an interprofessional screening approach}},
  author = {Melanie Rudelstorfer and Brigitte Mayr-Pirker and Eugen Trinka and Bernhard Iglseder and Richard Friedrich Radlberger},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = oct,
  doi = {10.3389/fneur.2026.1939701},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1939701/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Improving detection of candidates for botulinum toxin therapy in spasticity: an interprofessional screening approach
AU  - Melanie Rudelstorfer
AU  - Brigitte Mayr-Pirker
AU  - Eugen Trinka
AU  - Bernhard Iglseder
AU  - Richard Friedrich Radlberger
PY  - 2026
DA  - 2026/10/15
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1939701
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1939701/full
AB  - Background: Spastic movement disorders (SMD) are commonly treated with botulinum toxin, however, many patients who may benefit from treatment remain unrecognized in routine clinical practice. Early identification is particularly challenging in non-specialized settings. This study evaluated the diagnostic performance of interprofessional screening tools for identifying patients with clinically relevant SMD requiring referral for specialist assessment.  Methods: In this prospective, two-phase, single-center study, 124 patients who received care by departments of neurology and geriatrics were included. In phase 1, the Spastic Movement Disorder decision tree (SMD-DT) was applied independently by nurses, physiotherapists, and occupational therapists and compared with the clinical assessment of an experienced neurologist as the reference standard. Based on the findings, a simplified nursing screening tool, the Salzburg Nursing Questionnaire (SNQ), was developed and subsequently evaluated in independent cohorts in phase 2 of the study.  Results: The SMD-DT demonstrated high agreement with the reference standard in neurological rehabilitation settings, with a high degree of consistency across all professional groups compared with the expert, but showed substantially lower performance among nurses in non-specialized geriatric settings. In contrast, the SNQ consistently achieved high diagnostic accuracy in these settings (sensitivity of 1.00 and specificity of 0.96) considering treatment recommendation.  Conclusion: The diagnostic performance of screening instruments for SMD depends strongly on both clinical context and professional background. These findings support the implementation of profession-specific screening strategies to improve early recognition of clinically relevant SMD, facilitating timely referral for specialist evaluation, and optimize access to botulinum toxin therapy in routine clinical practice.
SN  - 1664-2295
ER  -