Spasticity in Focus, Expert Conversations in PM&R: Working with Other Specialists in Your Community-Session Recording

Video Transcription

Video Summary

This webinar focused on how PM&R physicians collaborate with other specialists in spasticity management. Dr. Heckert described case-based teamwork with orthopedic surgery and neurology. In one stroke patient, botulinum toxin helped but was insufficient until orthopedic tendon lengthening improved lower-limb and hand function. In another case, neurology referred a patient with unusual truncal spasms for ultrasound-guided rectus abdominis injections; when response was incomplete, further neurology workup was re-opened for a possible movement disorder.<br /><br />Dr. Salino discussed collaboration with anesthesiology and emergency medicine, emphasizing institutional protocols for patients with intrathecal baclofen pumps, especially perioperative pump management and emergency triage. He stressed that ER and anesthesia teams should know when to call PM&R, rather than relying on outside representatives or inappropriate reversal agents.<br /><br />Dr. Hafner focused on primary care and PT/OT collaboration. He highlighted the value of education, easy referral pathways, closed-loop communication, and therapy staff’s real-world insight into function and treatment response.<br /><br />Dr. Kwasnika reviewed neurosurgery and plastic surgery partnerships, including pump troubleshooting, catheter replacement, shunt concerns, neuromodulation planning, and selective neurectomy. Overall, the session emphasized proactive communication, shared treatment planning, and leveraging each specialty’s strengths to improve patient outcomes.

Keywords

PM&R

spasticity management

botulinum toxin

orthopedic surgery

neurology

intrathecal baclofen pump

physical therapy

occupational therapy

neurosurgery