Table 2.
Statements and consensus level at Round 2. TA Total Agreement; PA Partial agreement; DA Disagreement.
|
% TA |
% PA |
% DA |
|---|---|---|---|
| 1. After the stroke onset, it is recommended to propose a treatment with botulinum toxin type A (BoNT-A) as soon as the spasticity interferes, and the clinical conditions require it, regardless of the time interval elapsed after the acute event (subacute phase) |
|
||
| 2. It is necessary to monitor the patients after the acute event to verify the onset of post-stroke spasticity in order to propose a specific treatment for a period of at least one year |
|
||
| 3. It is necessary to monitor the patients over time after the acute event to verify the onset of post-stroke spasticity in order to propose a specific treatment, without a time limit but specifically in the first year |
|
||
| 4. After the onset of stroke, it is indicated to propose a spasticity treatment with BoNT-A in patients who are naïve in the presence of clinical needs, without time limitations |
|
||
| 5. For patients being treated with BoNT-A, a follow-up visit should be considered 4–6 weeks after BoNT-A injection |
|
||
| 6. For patients being treated with BoNT-A, after 12 months from the acute event a follow-up evaluation and a treatment are to be proposed every 3–6 months |
|
||
| 7. For patients being treated with BoNT-A, after the acute event, it is advisable to continue with follow-up and subsequent treatments until it is necessary, without time limits |
|
||
| 8. The objective of treatment with BoNT-A, if the patient is in the sub-acute or chronic phase, may be the same or different depending on the clinical conditions and/or objectives; in the acute phase, there is a greater chance of positively interfering with phenomena of maladaptive plasticity |
|
||
| 9. The goals of spasticity treatment with BoNT-A do not change if the patient is in the sub-acute or chronic phase |
|
||
| 10. The goals of spasticity treatment with BoNT-A are different if the patient is in the subacute or chronic phase |
|
||
| 11. For patients being treated with BoNT-A, both in subacute and chronic phases, the treatment schemes in place must be re-evaluated on each occasion in relation to the goals and in relation to the response to previous treatments |
|
||
| 12. The dose per muscle of BoNT-A used in the subacute phase tends to be the same or lower than in the chronic phase |
|
||
| 13. The dose per muscle of BoNT-A used in the subacute phase tends to be lower than in the chronic phase |
|
||
| 14. In the subacute phase, treatment with BoNT-A is focused more frequently in the upper limb |
|
||
| 15. In the subacute phase, treatment with BoNT-A is focused more frequently in the lower limb |
|
||