300 Section - Effectiveness of the MUSICA (Muscle Ultrasound for Spasticity Intelligent CAre) education program: a pre-post analysis of an ultrasound spasticity framework

Objectives : Assessing the effectiveness of the MUSICA education program through a pre-post analysis of an ultrasound (US) spasticity framework.

Design: Musculoskeletal US is an important tool to optimize targeting of botulinum type A (BoNT/A) treatment. The MUSICA curriculum consists of interactive virtual sessions and live (4-6 hours) workshops designed for physicians that are confident and experienced in using US for BoNT/A injections. The MUSICA framework is a conceptual framework created by international experts. It is based on the 5 Clinical Pearls; reinforce anatomy learning, use comparative anatomy, localise muscles, assess muscle architectural changes, and the ABC-checklist (including ergonomics, knobology and confident injection) and complements existing US courses by providing a higher level framework for spastic muscle assessment and optimal delivery of BoNT/A treatment. Program impact was measured using a pre-post course structured knowledge check for 1 workshop and participant feedback surveys for all virtual sessions and live workshops.

Results: Knowledge scores from a live workshop with n=14 physicians (85% with >5 years of US experience) increased by 31% from baseline: 67% correct responses before to 87% post-training. Among 70 workshop attendees across 3 workshops, over 90% endorsed the MUSICA Framework's value for daily practice and expressed high satisfaction with the workshop content. Virtual sessions with >300 participants were also valued by 93%.

Conclusion: The MUSICA Education Program centered on the 5 Clinical Pearls, complements existing ultrasound spasticity courses. Preliminary results suggest a strong gain in knowledge that may enhance physicians' knowledge, confidence and procedural skills in US-guided spasticity management. Positive participant feedback supports further expansion of the MUSICA program and highlights the importance of a framework approach when using ultrasound as a relevant tool in spasticity management.