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Presented by the Johns Hopkins University School of Medicine.
Supported by an educational grant from Allergan, Inc.


OVERVIEW

Spasticity occurs across the spectrum of upper motor neuron disease and complicates the course and quality of life of those affected. It contributes to pain, insomnia, and fatigue; can interfere with mobility, transfers, self-care, activities of daily living, and social functioning; and increases caregiver burden. This activity will discuss the pathophysiology and definition of spasticity to aide in patient evaluation, assess the usefulness and limitations of various scales used for evaluation, and describe available treatments and clinically relevant distinctions in dosing and bioavailability between chemodenervation agents that are available for the management of spasticity in adults and children to help clinicians improve patient quality of life.

GOAL

The goal of this activity is to focus on methods for improving the quality of life for patients with spasticity.

TARGET AUDIENCE

This activity is designed for physiatrists, neurologists, and allied health professionals who treat patients with spasticity. No prerequisites required.

LEARNING OBJECTIVES

After completing this activity, the participant will demonstrate the ability to:

  • Discuss evaluation and treatment goals in patients with spasticity.
  • Develop treatment algorithms for adults and children with localized and generalized spasticity.
  • Identify appropriate muscles for injection in various upper motor neuron syndromes.
  • Describe available treatments and clinically relevant distinctions in dosing and bioavailability between chemodenervation agents available for the management of spasticity in adults and children.
The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

ACCREDITATION STATEMENT

The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT

The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

After reviewing this online activity, participants may receive credit by completing the CME test, evaluation, and receiving a score of 75% or higher.

The estimated time to complete this activity: 0.5 hours.

Release date: March 29, 2012. Expiration date: March 29, 2014.

Full Disclosure Policy Affecting CME Activities
As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentation. The following relationships have been reported for this activity:

Co-Chair and Planner
Zoltan Mari, MD

Director
National Parkinson Foundation Center of Excellence
Assistant Professor of Neurology
Johns Hopkins University School of Medicine

Co-Chair and Planner
R. Samuel Mayer, MD

Assistant Professor
Vice Chair for Education
Department of Physical Medicine and Rehabilitation
Johns Hopkins University School of Medicine
Deputy Director, Quality Improvement
Department of Physical Medicine and Rehabilitation
The Johns Hopkins Hospital

Participating Faculty
Melissa K. Trovato, MD

Faculty
Kennedy Krieger Institute
Assistant Professor of Physical Medicine and Rehabilitation
Johns Hopkins University School of Medicine

Participating Faculty Disclosures
Zoltan Mari, MD, reports serving as the principal investigator on grants/research support received from Allergan, Inc and theNational Parkinson Foundation; receiving grants/research support from Ipsen, Merz Pharma, and Teva; serving as a consultantfor Merz Pharma; and serving on the advisory board for Ipsen.

R. Samuel Mayer, MD, reports receiving unrestricted educational grant from Allergan, Inc to support residency training program.

No other speakers have indicated that they have any financial interests or relationships with a commercial entity whose productsor services are relevant to the content of their presentation(s).

Planner Disclosures
Zoltan Mari, MD, reports serving as the principal investigator on grants/research support received from Allergan, Inc and the National Parkinson Foundation; receiving grants/research support from Ipsen, Merz Pharma, and Teva; serving as a consultant for Merz Pharma; and serving on the advisory board for Ipsen.

R. Samuel Mayer, MD, reports receiving unrestricted educational grant from Allergan, Inc to support residency training program.

No other planners have indicated that they have any financial interests or relationships with a commercial entity.

Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

Off-Label Product Discussion

The following faculty members have disclosed that their presentation will reference unlabeled/unapproved use of drugs or products:

R. Samuel Mayer, MD: phenol
Melissa K. Trovato, MD: onabotulinumtoxinA and rimabotulinumtoxinB

DISCLAIMER
The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.

INTERNET CME POLICY

The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals, and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet based activity. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine’s CME activity. CME collects only the information necessary to provide you with the services that you request.

CONFIDENTIALITY DISCLAIMER FOR CME ACTIVITY PARTICIPANT

I certify that I am participating in this Johns Hopkins University School of Medicine activity for CME-accredited training and/or educational purposes.

I understand that while I am participating in this capacity, I may be exposed to "protected health information," as that term is defined and used in Johns Hopkins policies and in the federal HIPAA privacy regulations (the "Privacy Regulations"). Protected health information is information about a person’s health or treatment that identifies the person. I also understand that while I am participating in this capacity I will be treated as a temporary member of Johns Hopkins for purposes of the Privacy Regulations only.

I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential.

I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is: Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.

“The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as sponsor of this activity, has relayed information with the CME attendees/participants and certify that the visitor is here for training, education and/or observation purposes only.”

Johns Hopkins University School of Medicine
Office of Continuing Medical Education
720 Rutland Avenue/ Turner 20
Baltimore, MD 21205-2195
Reviewed & Approved by: General Counsel, Johns Hopkins Medicine (4/1/09)

HARDWARE AND SOFTWARE REQUIREMENTS

Pentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, sound card and speakers, Adobe Acrobat Reader.

ACTIVITY CONTENTS

Please complete the pre-test, listen to the following presentation, and complete the post-test and evaluation to receive CME credit for this activity.

Pre-Test

Treatment Algorithms

R. Samuel Mayer, MD

Toxins Available
Zoltan Mari, MD

Managing Spasticity Case(s)
R. Samuel Mayer, MD

Managing Pediatric Spasticity Case(s)
Melissa K. Trovato, MD

Post-Test

procced to pretest




Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.