300 Section - Mapping the evidence on spasticity in long term care facilities: A scoping review

Objectives : Spasticity commonly develops following upper motor neuron injury and is associated with pain, reduced mobility, functional decline, and increased caregiver burden. As neurological conditions progress, many affected individuals require placement in long-term care (LTC) facilities. Despite the potential impact of spasticity on residents and care delivery, the LTC-specific literature remains fragmented and has not been comprehensively synthesized. To map the extent, range, and nature of the existing literature on spasticity among residents of LTC facilities and identify gaps to inform future research and clinical practice.

Design: This scoping review was conducted in accordance with Joanna Briggs Institute methodology and reported following the PRISMA-ScR guidelines. MEDLINE, Embase, CINAHL, Scopus, Web of Science, and CENTRAL were searched. Two reviewers independently screened titles/abstracts and full texts using predefined inclusion criteria. Data extraction was performed using a standardized tool. Findings were synthesized descriptively.

Results: Twenty-one studies published between 2012 and 2025 met the inclusion criteria. Most studies were observational in design, with cross-sectional and prevalence studies predominating; a smaller number evaluated interventional approaches, primarily focal treatments such as botulinum toxin injections or phenol nerve blocks. Studies were conducted across diverse long-term care settings, including nursing homes, care homes, veterans’ facilities, and long-term care hospitals, and represented more than 3,800 residents overall. Participants were predominantly older adults, with most studies reporting mean or median ages in the late 70s to mid-80s. The literature most frequently addressed spasticity prevalence, assessment and screening methods, and the impact of spasticity on care delivery, including hygiene, activities of daily living, and caregiver burden.

Conclusion: The existing literature demonstrates that spasticity is common in long-term care and substantially affects care delivery, yet evidence remains largely observational and narrowly focused. Future research should prioritize standardized LTC-specific assessment pathways, interdisciplinary management strategies, and resident-centred outcomes.