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I -Optimizing Spasticity

Spotlight Best Practice Organization Spinal Cord Injury Program – Health Sciences Centre Winnipeg Winnipeg Regional Health Authority, Winnipeg Winnipeg has an interdisciplinary approach to long-term spasticity management, with two SCI physiatrists leading a multidisciplinary management program. Treatments are always goal directed and patient focused, with input from the patients, caregivers and team members, prior to defining realistic and obtainable goals. These range from education provided by the nurse or pharmacist, and physical modalities from the OT and PT; orthosis provision by the orthotist, to medical therapy offered by the physiatrist, or other team members. This centre has extensive clinical experience using a range of medical therapies - from oral medications to botulinum toxin and, more recently, phenol (in select cases) and intrathecal pumps. The intrathecal baclofen pump program has been running for over two decades, and is unique because pump therapy is offered to select geographically remote patients, through provision of different types of pumps. Newer techniques such as Saebo splints and Bioness FES have also been incorporated into the program service delivery models. The program is supported by active clinical research in this area, and evaluation of the efficacy of numerous drug therapies (in the past) including baclofen, cyproheptadine, tizanidine, fampridine, intrathecal baclofen and, most recently, cannabinoids. OPTIMIZING SPASTICITY | BODY STRUCTURE AND FNUCTION 95


I -Optimizing Spasticity
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