{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T04:21:13Z","timestamp":1786594873493,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Spanish Society of Physical Medicine and Rehabilitation","award":["02\/2023"],"award-info":[{"award-number":["02\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Background: Spasticity, which occurs with certain neurological conditions, substantially affects quality of life, function, and social participation. Despite widespread botulinum toxin use, variability persists in patient information, access to specialized rehabilitation, and follow-up models. Methods: This two-phase Delphi-Dialogue Patients\u2013Professionals study (DDPP), promoted by SERMEF, integrated perspectives from 77 patients and 141 rehabilitation professionals. Phase 1 used parallel surveys to assess satisfaction, perceived effectiveness of botulinum toxin, communication preferences, and rehabilitation follow-up. Phase 2 applied Real-Time Delphi with 38 experts to generate consensus recommendations to improve spasticity management. Results: Patients and professionals agreed on botulinum toxin benefits, the importance of ongoing rehabilitation, and the value of hybrid (in-person\/remote) follow-up. Key gaps concerned access to Physical Medicine and Rehabilitation services, clarity and timing of information, and shared goal setting. Experts translated these misalignments into 10 prioritized recommendations, with highest feasibility for actions standardizing access pathways, optimizing botulinum toxin use, reinforcing structured education, and consolidating hybrid rehabilitation models. Conclusions: The DDPP approach offers a reproducible framework to align stakeholder perspectives by converting quantified divergence into consensus-based innovation priorities. Implementing the recommendations\u2014particularly those strengthening communication, education, and hybrid pathways regarding botulinum toxin treatment\u2014may support more accessible, personalized, patient-centered spasticity care.<\/jats:p>","DOI":"10.3390\/toxins18010056","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T18:35:56Z","timestamp":1769193356000},"page":"56","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Aligning Minds in Spasticity Care\u2014A Two-Phase Delphi-Dialogue Study of Patients and Professionals in Spain"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2656-1709","authenticated-orcid":false,"given":"Helena","family":"Bascu\u00f1ana-Ambr\u00f3s","sequence":"first","affiliation":[{"name":"Physical Medicine and Rehabilitation Department, Sant Pau University Hospital, 08041 Barcelona, Spain"},{"name":"Spanish Society of Physical Medicine and Rehabilitation (SERMEF), 28016 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8023-474X","authenticated-orcid":false,"given":"Jacobo","family":"Formigo-Couceiro","sequence":"additional","affiliation":[{"name":"Spanish Society of Physical Medicine and Rehabilitation (SERMEF), 28016 Madrid, Spain"},{"name":"Physical Medicine and Rehabilitation Department, A Coru\u00f1a University Hospital, 15006 A Coru\u00f1a, Spain"},{"name":"Rehabilitation Research Group, Biomedical Research Institute of A Coru\u00f1a (INIBIC), 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Maria","family":"Climent-Barber\u00e1","sequence":"additional","affiliation":[{"name":"Spanish Society of Physical Medicine and Rehabilitation (SERMEF), 28016 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lluis","family":"Guirao-Cano","sequence":"additional","affiliation":[{"name":"Spanish Society of Physical Medicine and Rehabilitation (SERMEF), 28016 Madrid, Spain"},{"name":"Physical Medicine and Rehabilitation Department, Mutua de Terrassa University Hospital, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9200-1976","authenticated-orcid":false,"given":"Michelle","family":"Catta-Preta","sequence":"additional","affiliation":[{"name":"Innex Labs, 08800 Vilanova i la Geltr\u00fa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4142-083X","authenticated-orcid":false,"given":"Alex","family":"Trejo-Ome\u00f1aca","sequence":"additional","affiliation":[{"name":"Innex Labs, 08800 Vilanova i la Geltr\u00fa, Spain"},{"name":"Escola Polit\u00e8cnica Superior d\u2019Enginyeria de Vilanova i la Geltr\u00fa (EPSEVG), Universitat Polit\u00e8cnica de Catalunya, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep Maria","family":"Monguet-Fierro","sequence":"additional","affiliation":[{"name":"Innex Labs, 08800 Vilanova i la Geltr\u00fa, Spain"},{"name":"Escola Polit\u00e8cnica Superior d\u2019Enginyeria de Vilanova i la Geltr\u00fa (EPSEVG), Universitat Polit\u00e8cnica de Catalunya, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1007\/s00415-018-8759-1","article-title":"Defining spasticity: A new approach considering current movement disorders terminology and botulinum toxin therapy","volume":"265","author":"Dressler","year":"2018","journal-title":"J. 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