National Collaborating Centre for Women's and Children's Health

Contents
1 Guideline summary 1
1.1 Guideline development group membership, NCC-WCH staff and acknowledgements 1
1.2 Foreword 2
1.3 Care pathway 2
1.4 Key priorities for implementation 11
1.5 Recommendations 13
1.6 Key research recommendations 29
1.7 Research recommendations 32
1.8 Schedule for updating the guideline 34
2 Introduction 35
2.1 Spasticity and co-existing motor disorders 35
2.2 For whom is this guideline intended? 39
2.3 Related NICE guidance 39
3 Guideline development methodology 40
3.1 Methodology 40
3.2 Developing review questions and protocols and identifying evidence 40
3.3 Reviewing and synthesising evidence 41
3.4 Incorporating health economics 42
3.5 Evidence to recommendations 43
3.6 Stakeholder involvement 43
3.7 Specific considerations for this guideline 43
4 Physical therapy (physiotherapy and/or occupational therapy) 45
5 Orthoses 79
6 Oral drugs 111
7 Botulinum toxin 130
8 Intrathecal baclofen 171
9 Orthopaedic surgery 208
10 Selective dorsal rhizotomy 225
11 Health economics 262
11.1 Introduction 262
11.2 Physical therapy (physiotherapy and/or occupational therapy) 263
11.3 Orthoses 265
11.4 Botulinum toxin 266
11.5 Intrathecal baclofen 270
11.6 Orthopaedic surgery 279
11.7 Selective dorsal rhizotomy 280
11.8 Overall conclusions 282
12 References 284
13 Abbreviations and glossary 291
13.1 Abbreviations 291
13.2 Glossary 293
Appendices A to L are in separate files.
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