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Neurological Rehabilitation

Impact of a Comprehensive Neurorehabilitation and Spasticity Management Fellowship

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 10

    Primary Author(s)

  • Sarah Golus, Other

    Clinical Research Coordinator
    Medical College of Wisconsin Affiliated Hospitals PM&R Program
    Oak Creek, Wisconsin

    • Co-Author(s)

  • John R. McGuire, MD

    Professor PM&R
    Medical College of Wisconsin Affiliated Hospitals PM&R Program
    Brookfield, Wisconsin

Disclosure(s):
Sarah Golus, Other: No financial relationships to disclose
John R. McGuire, MD: No relevant disclosure to display
Background and/or Objectives: There continues to be an unmet need for comprehensive spasticity management in this country. To address this need, we developed the first Comprehensive Neurorehabilitation and Spasticity Management Fellowship in 2008 to train physicians with the goal to increase providers who could offer specialized spasticity care. To date, we have trained 16 fellows, the most in the country. The objective of this research project was to use a survey to measure the impact of a comprehensive neurorehabilitation and spasticity management fellowship on post residency practice.

Design: Exploratory Survey

Setting : Academic Medical Center

Participants : 2008-2025 Graduates of Comprehensive Neurorehabilitation and Spasticity Management Fellowship

Interventions: 1 year spasticity management and neurorehabilitation fellowship

Main Outcome Measures: Determine 1) the skills acquired during the fellowship, 2) how the fellowship impacted post-training practice, 3) the fellow’s ability to handle complex spasticity patients.

Results: A total of 14/16 fellows completed the survey regarding their spasticity fellowship education, training, and post graduate practice. Descriptive statistics (minimum, maximum and means) were calculated and found that 57.73% of their post fellowship practice involved spasticity and dystonia cases. 56.5% of fellows practice involved neurotoxin injections while 7% of their practice centered around intrathecal baclofen pump care. 91% of the fellows responded that the fellowship was more impactful on their practice than they expected and 82% indicated that they feel more prepared to deal with complex cases when compared to their practice partners.

Conclusions: Problematic spasticity is undertreated in this country and there are not enough training programs for physicians to become skilled in comprehensive spasticity management. Spasticity fellowships can help meet this unmet need by increasing the number of physicians who can provide this specialized care. Further studies will investigate comparing practice patterns of fellowship trained physicians versus non fellowship trained physicians.