Date: Tuesday 4 Nov. 2025

Topic Spasticity
Main Speaker Rajiv Reebye Canada
Co Speakers Ève Boissonnault Canada, Anton Pick UK, Stefano Carda Switzerland, Omar Khan 
Attendees 50
Extra Fees Supported par MerZ

Ultrasound (US) is an important tool for performing chemodenervation and diagnostic nerve blocks in the treatment of spasticity.

The role of ultrasound in spasticity management has been well discussed literature. (Alter & Karp, 2017; Winston et al., 2023) In addition, US guidance may help clinicians in the long-term assessment and follow-up of muscle quality. (Moreta et al., 2020) There is great interest amongst physicians specialized in spastic motor disorders regarding the ability to differentiate the degree of echo intensity in patients with an upper motoneuron pathology due to recent literature suggesting that echogenicity has the potential to influence response to spasticity treatment, including response to botulinum toxin injections.

(Picelli et al., 2012; Hara et al., 2018) Our group of physiatrists with expertise in spasticity management has been collaborating and contributing to the literature on the use of US for spasticity assessment and management over the last few years.

(Francisco et al., 2021; Lagnau et al., 2021; Winston et al., 2023; Kassam et al., 2023; Boissonnault et al., 2024; Heslot et al., 2024; McRae et al. 2024) The focus of this workshop is to provide clinical pearls to enhance the use of ultrasound in the research and clinical settings.

Chairs Rajiv Reebye, Stefano Carda

16H30 Panelists’ introduction

16H35 Background and review of the literature on muscle architectural changes in spastic disorders and presentation of the Modified Heckmatt scale

16H55 Live demonstration in 4 small groups:
• Sharing of clinical pearls on proper US scanning and injection techniques
• Identificayion of nerves
• Identificayion of muscles
• Explaining how to incorporate the Modified Heckma Scale in a clinical setting

17H30 Potential application of the Modified Heckma scale in a clinical setting and future directions

17H45 Hands-on practice of learned practical clinical pearls on proper US scanning and injection techniques, including muscle assessment with the Modified Heckma scale
Four stations :
1. Ergonomics/Knobology and enhancing injection technique
2. Ultrasound identification of muscles
3. Ultrasound identification of key nerves
4. Elevator technique for identification of key muscles to be injected upper and lower limb spasticity