Session Information
Date: Tuesday, September 24, 2019
Session Title: Spasticity
Session Time: 1:45pm-3:15pm
Location: Les Muses Terrace, Level 3
Objective: To test the effectiveness of teleneurology for spasticity screening.
Background: Spasticity is underdiagnosed and can pose significant problems when not treated. Unfortunately, according to a 2013 Association of American Medical Colleges Center for Workforce Studies report, the ratio of neurologists to patients in Tennessee is 1:28,567. Teleneurology is widely deployed to address the shortage of specialist physicians in community and rural settings. To test the effectiveness of utilizing teleneurology to screen for spasticity, movement disorders neurologists used hand-held technology facilitated by a bedside nurse to remotely screen for the signs or symptoms of spasticity in residents with intellectual disabilities residing in a long-term care facility.
Method: In-person examinations of residents (n=17) with intellectual disabilities residing in a long-term care facility were performed by a movement disorders neurologist to determine the presence of spasticity. After the in-person exam, two different movement disorders neurologists independently connected via telehealth technology to a bedside nurse facilitating an abbreviated screening examination for signs or symptoms suggesting the possible presence of spasticity.
Results: The two telehealth neurology examiners had a sensitivity of 73% and 82%, a negative predictive value (NPV) of 63% and 71%, and a specificity and positive predictive value (PPV) of 100% in the identification of spasticity. There was almost perfect agreement between the two telehealth neurologists (Kappa = 0.88, 95%CI 0.64-1.00). One participant withdrew consent and was not included in these analyses.
Conclusion: Screening patients with intellectual disabilities for spasticity utilizing teleneurology demonstrated high sensitivity and NPV, as well as perfect specificity and PPV. Our findings suggest that teleneurology is a reliable mechanism that could aid in identifying individuals who would benefit from referral for evaluation and treatment of spasticity. Additional research with a larger subject population is needed to validate these findings.
To cite this abstract in AMA style:
K. Harper, B. Eoff, F. Phibbs, D. Isaacs, S. Gallion, E. Thomas, J. Scott, M. Hacker, D. Charles. Is teleneurology effective in screening for spasticity? [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/is-teleneurology-effective-in-screening-for-spasticity/. Accessed June 15, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/is-teleneurology-effective-in-screening-for-spasticity/