{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:47:59Z","timestamp":1788526079240,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum D\u00fcsseldorf. Anstalt \u00f6ffentlichen Rechts"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nervenarzt"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>In bis zu 43\u202f% der F\u00e4lle entwickelt sich in Folge eines Schlaganfalls eine spastische Bewegungsst\u00f6rung (\u201espastic movement disorder\u201c, SMD). Beim Vorliegen einer funktions- oder alltagsrelevanten SMD oder zur Vermeidung von Komplikationen wird die medikament\u00f6se Behandlung einer fokalen, multifokalen und segmentalen spastischen Tonuserh\u00f6hung mit Botulinumneurotoxin\u00a0A (BoNT-A) empfohlen. Versorgungsdaten dokumentieren jedoch einen Mangel an einer leitliniengerechten Versorgung in Deutschland.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Fragestellung<\/jats:title>\n                <jats:p>Ziel des berichteten Expertentreffens war es, L\u00f6sungswege aus der Fehl- und Unterversorgung f\u00fcr Patient*innen mit SMD zu diskutieren und eine Konsensusempfehlung zur Verbesserung der Versorgung zu formulieren.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methoden<\/jats:title>\n                <jats:p>Auf einem im April 2022 durchgef\u00fchrten Konsensus-Meeting diskutierten acht Expertinnen und Experten aus den Bereichen Neurologie, Physikalische Medizin und Rehabilitation die Ursachen der Fehl- und Unterversorgung und formulierten konsentierte L\u00f6sungsans\u00e4tze.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Gr\u00fcnde der aktuellen Fehl- und Unterversorgung im SMD-Management in Deutschland umfassen ein unzureichendes Bewusstsein f\u00fcr SMD bei \u00c4rztinnen und \u00c4rzten, fehlende Behandlungskapazit\u00e4ten, mangelnde Informations\u00fcbermittlung im Entlassungsmanagement und Personalmangel in spezialisierten station\u00e4ren und ambulanten Therapiezentren. Das Gremium empfiehlt daher einen Patientenpfad, bei dem Betroffene mit SMD einer sachgerecht umgesetzten BoNT-A-Therapie in Kombination mit physikalischen Ma\u00dfnahmen zugef\u00fchrt werden.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Diskussion<\/jats:title>\n                <jats:p>Der empfohlene Versorgungspfad zur Anwendung bei Patient*innen nach Schlaganfall soll Versorgungsl\u00fccken schlie\u00dfen und damit eine leitliniengerechte Behandlung der SMD nach Schlaganfall gew\u00e4hrleisten.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00115-023-01571-8","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T12:01:52Z","timestamp":1700568112000},"page":"133-140","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Verbesserung der Versorgung von Patientinnen und Patienten mit spastischer Bewegungsst\u00f6rung nach Schlaganfall","Improvement of the treatment of patients with spastic movement disorder after stroke"],"prefix":"10.1007","volume":"95","author":[{"given":"John-Ih","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albrecht","family":"G\u00fcnther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Paus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Royl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Weyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Wissel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten E.","family":"Zeuner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Klebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"1571_CR1","unstructured":"Die Spastik-app. https:\/\/www.spastik-app.de\/die-app. Zugegriffen: 19. Jan. 2023"},{"key":"1571_CR2","first-page":"540","volume":"192","author":"B Ashworth","year":"1964","unstructured":"Ashworth\u00a0B (1964) Preliminary trial of carisoprodol in multiple sclerosis. Practitioner 192:540\u2013542","journal-title":"Practitioner"},{"key":"1571_CR3","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","volume":"67","author":"RW Bohannon","year":"1987","unstructured":"Bohannon\u00a0RW, Smith\u00a0MB (1987) Interrater reliability of a\u00a0modified ashworth scale of muscle spasticity. Phys Ther 67:206\u2013207","journal-title":"Phys Ther"},{"key":"1571_CR4","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1080\/10749357.2020.1843845","volume":"28","author":"S Glaess-Leistner","year":"2021","unstructured":"Glaess-Leistner\u00a0S, Ri\u00a0SJ, Audebert\u00a0HJ et al (2021) Early clinical predictors of post stroke spasticity. Top Stroke Rehabil 28:508\u2013518","journal-title":"Top Stroke Rehabil"},{"key":"1571_CR5","doi-asserted-by":"crossref","unstructured":"Gozum M, Rosales R (2016) Botulinum toxin a therapy in early post-stroke spasticity: providing a wider treatment avenue. Int J Neurorehabilitation Eng (3)","DOI":"10.4172\/2376-0281.1000207"},{"key":"1571_CR6","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1177\/2396987318771174","volume":"3","author":"B Hotter","year":"2018","unstructured":"Hotter\u00a0B, Padberg\u00a0I, Liebenau\u00a0A et al (2018) Identifying unmet needs in long-term stroke care using in-depth assessment and the post-stroke checklist\u2014the managing aftercare for stroke (MAS-I) study. Eur Stroke\u00a0J 3:237\u2013245","journal-title":"Eur Stroke J"},{"key":"1571_CR7","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1007\/s00115-017-0312-4","volume":"88","author":"L Kerkemeyer","year":"2017","unstructured":"Kerkemeyer\u00a0L, Lux\u00a0G, Walendzik\u00a0A et\u00a0al (2017) Medical care of patients with spasticity following stroke : evaluation of the treatment situation in Germany with focus on the use of botulinum toxin. Nervenarzt 88:919\u2013928","journal-title":"Nervenarzt"},{"key":"1571_CR8","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1055\/s-0034-1385231","volume":"82","author":"M Kohler","year":"2014","unstructured":"Kohler\u00a0M, Deutschbein\u00a0J, Peschke\u00a0D et al (2014) Stroke occurence in Germany\u2014on the comparability of insurance data and registry-based data. Fortschr Neurol Psychiatr 82:627\u2013633","journal-title":"Fortschr Neurol Psychiatr"},{"key":"1571_CR9","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1212\/WNL.30.12.1303","volume":"30","author":"JW Lance","year":"1980","unstructured":"Lance\u00a0JW (1980) The control of muscle tone, reflexes, and movement: robert wartenberg lecture. Neurology 30:1303\u20131313","journal-title":"Neurology"},{"key":"1571_CR10","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1111\/j.1468-1331.2008.02114.x","volume":"15","author":"E Lundstr\u00f6m","year":"2008","unstructured":"Lundstr\u00f6m\u00a0E, Ter\u00e9nt\u00a0A, Borg\u00a0J (2008) Prevalence of disabling spasticity 1\u00a0year after first-ever stroke. Eur J Neurol 15:533\u2013539","journal-title":"Eur J Neurol"},{"key":"1571_CR11","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1097\/PHM.0000000000000157","volume":"93","author":"A Opheim","year":"2014","unstructured":"Opheim\u00a0A, Danielsson\u00a0A, Alt Murphy\u00a0M et al (2014) Upper-limb spasticity during the first year after stroke: stroke arm longitudinal study at the university of Gothenburg. Am J Phys Med Rehabil 93:884\u2013896","journal-title":"Am J Phys Med Rehabil"},{"key":"1571_CR12","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1080\/09638280400014576","volume":"27","author":"AD Pandyan","year":"2005","unstructured":"Pandyan\u00a0AD, Gregoric\u00a0M, Barnes\u00a0MP et\u00a0al (2005) Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil 27:2\u20136","journal-title":"Disabil Rehabil"},{"key":"1571_CR13","doi-asserted-by":"publisher","first-page":"e173","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.10.016","volume":"22","author":"I Philp","year":"2013","unstructured":"Philp\u00a0I, Brainin\u00a0M, Walker\u00a0MF et al (2013) Development of a\u00a0poststroke checklist to standardize follow-up care for stroke survivors. J\u00a0Stroke Cerebrovasc Dis 22:e173\u2013180","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"1571_CR14","volume-title":"S2k-Leitlinie. Deutsche Gesellschaft f\u00fcr Neurologie, Leitlinien f\u00fcr Diagnostik und Therapie in der Neurologie","author":"T Platz","year":"2018","unstructured":"Platz\u00a0T (2018) Therapie des spastischen Syndroms. In: S2k-Leitlinie. Deutsche Gesellschaft f\u00fcr Neurologie, Leitlinien f\u00fcr Diagnostik und Therapie in der Neurologie"},{"key":"1571_CR15","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1080\/09638280701191743","volume":"30","author":"T Platz","year":"2008","unstructured":"Platz\u00a0T, Vuadens\u00a0P, Eickhof\u00a0C et\u00a0al (2008) REPAS, a\u00a0summary rating scale for resistance to passive movement: item selection, reliability and validity. Disabil Rehabil 30:44\u201353","journal-title":"Disabil Rehabil"},{"issue":"19","key":"1571_CR16","doi-asserted-by":"crossref","first-page":"65","DOI":"10.24945\/MVF.03.19.1866-0533.2149","volume":"3","author":"C Potempa","year":"2019","unstructured":"Potempa\u00a0C, Thiem\u00a0H, Rychlik\u00a0R et\u00a0al (2019) On the care situation of patients with spastic movement disorders in Germany. Monit Versorgungsforsch 3(19):65\u201372","journal-title":"Monit Versorgungsforsch"},{"key":"1571_CR17","doi-asserted-by":"publisher","first-page":"jrm00169","DOI":"10.2340\/16501977-2803","volume":"53","author":"S Ri","year":"2021","unstructured":"Ri\u00a0S, Glaess-Leistner\u00a0S, Wissel\u00a0J (2021) Early brain imaging predictors of post-stroke spasticity. J\u00a0Rehabil Med 53:jrm169","journal-title":"J Rehabil Med"},{"key":"1571_CR18","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1161\/01.STR.0000105386.05173.5E","volume":"35","author":"DK Sommerfeld","year":"2004","unstructured":"Sommerfeld\u00a0DK, Eek\u00a0EU, Svensson\u00a0AK et\u00a0al (2004) Spasticity after stroke: its occurrence and association with motor impairments and activity limitations. Stroke 35:134\u2013139","journal-title":"Stroke"},{"key":"1571_CR19","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1055\/s-0043-119192","volume":"22","author":"H Thiem","year":"2017","unstructured":"Thiem\u00a0H, Bretzke\u00a0P, Rebscher\u00a0H (2017) Behandlung und Pflege von Schlaganfallpatienten \u2013 Zur Spastik nach Schlaganfall und den damit assoziierten volkswirtschaftlichen Kosten. Gesundh \u00f6kon Qual manag 22:227\u2013230","journal-title":"Gesundh \u00f6kon Qual manag"},{"key":"1571_CR20","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1161\/STROKEAHA.110.581991","volume":"41","author":"PP Urban","year":"2010","unstructured":"Urban\u00a0PP, Wolf\u00a0T, Uebele\u00a0M et\u00a0al (2010) Occurence and clinical predictors of spasticity after ischemic stroke. Stroke 41:2016\u20132020","journal-title":"Stroke"},{"key":"1571_CR21","first-page":"81","volume":"4","author":"L V\u00f6lkel","year":"2022","unstructured":"V\u00f6lkel\u00a0L, Rebscher\u00a0H, Rychlik\u00a0R (2022) Versorgungssituation von Patient:innen mit spastischer Bewegungsst\u00f6rung in station\u00e4ren Pflegeeinrichtungen in Deutschland. Monit Versorgungsforsch 4:81\u201387","journal-title":"Monit Versorgungsforsch"},{"key":"1571_CR22","doi-asserted-by":"publisher","first-page":"S13","DOI":"10.1212\/WNL.0b013e3182762448","volume":"80","author":"J Wissel","year":"2013","unstructured":"Wissel\u00a0J, Manack\u00a0A, Brainin\u00a0M (2013) Toward an epidemiology of poststroke spasticity. Neurology 80:S13\u2013S19","journal-title":"Neurology"},{"key":"1571_CR23","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.pmrj.2014.08.946","volume":"7","author":"J Wissel","year":"2015","unstructured":"Wissel\u00a0J, Verrier\u00a0M, Simpson\u00a0DM et al (2015) Post-stroke spasticity: predictors of early development and considerations for therapeutic intervention. PM\u00a0R 7:60\u201367","journal-title":"PM R"},{"key":"1571_CR24","unstructured":"Zaragatski E, Schramm A, Maisonobe P et al (2022) Protocol for the SMART study: effectiveness and safety of SMART BoNT\u2011A therapy with dysport\u00ae in patients with post-stroke chronic upper limb spasticity in real-life setting. Dtsch Kongr Park Bewegungsst\u00f6rungen"}],"container-title":["Der Nervenarzt"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00115-023-01571-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00115-023-01571-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00115-023-01571-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T13:04:45Z","timestamp":1707311085000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00115-023-01571-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,21]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["1571"],"URL":"https:\/\/doi.org\/10.1007\/s00115-023-01571-8","relation":{},"ISSN":["0028-2804","1433-0407"],"issn-type":[{"value":"0028-2804","type":"print"},{"value":"1433-0407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,21]]},"assertion":[{"value":"25 October 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"J.-I.\u00a0Lee: Vortrags- und Beraterhonorare oder Reise- und Unterbringungskosten von Boehringer-Ingelheim, Daiichi Sankyo, Allergan\/Abbvie, Ipsen, Novartis, Teva, Lilly, Merz, Bayer, Pfizer. Forschungsf\u00f6rderung von Merz. A.\u00a0G\u00fcnther: Vortrags- und Beraterhonorare oder Reise- und Unterbringungskosten von Ipsen, Boehringer-Ingelheim, Bristol Myers Squibb, Pfizer, Occlutech, Daiichi Sankyo, Merz. S.\u00a0Paus: Berater f\u00fcr: Bial, Idorsia, Ipsen, Merz, TEVA. Vortr\u00e4ge und Fortbildungen f\u00fcr AbbVie, Bayer, Bial, Ipsen, Merz, Novartis. Teilnahme an klinischen Studien (Phasen\u00a0II und\u00a0III): Bayer, Ipsen, Syneos Health. G.\u00a0Royl: Vortrags- und Beraterhonorare sowie Reise- und Unterbringungskosten bei Kongressen erhalten von Ipsen, Boehringer-Ingelheim, Bristol Myers Squibb und Daiichi Sankyo. U.\u00a0Weyen: Ipsen Pharma GmbH und Merz Therapeutics. J.\u00a0Wissel: Adboardteilnehmer bei Abbvie, Merz, Ipsen und Medtronic; Vortragender f\u00fcr Abbvie, Merz, Ipsen, Medtronic; Mitglied im Board of Directors der International Neurotoxin Association; Chair der Spasticity Study Group der Movement Disorder Society; Mitglied der Leitlinienkommission der DGN zur Therapie des spastischen Syndroms, S2k-Leitlinie. Deutsche Gesellschaft f\u00fcr Neurologie 2018. K.E.\u00a0Zeuner: Referentin f\u00fcr Ipsen Pharma GmbH, Merz Therapeutics, Pharm Allergan GmbH, AbbVie, Bial, Bayer und Alexion Pharma Germany GmbH; Beratert\u00e4tigkeiten f\u00fcr Merz Therapeutics, Ipsen Pharma GmbH, Pharm Allergan GmbH, Alexion Pharma Germany GmbH, Bial, AbbVie; Gutachterliche T\u00e4tigkeiten: Bundesinstitut f\u00fcr Arzneimittel und Medizinprodukte; Wissenschaftliche Unterst\u00fctzung durch die Firma Strathmann GmbH & Co. KG und die Christa und Hans-Peter Thomsen Stiftung. S.\u00a0Klebe: Vortrags- und Beraterhonorare oder Reise- und Unterbringungskosten Abbvie, Ipsen, Stada Pharm, Boston Scientific, Bial, Esteve.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autor\/-innen keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}