Redefining Spasticity: The Spasticity X Working Group Consensus Statement.

Authors

Gerard Francisco, Anand Pandyan, Sheng Li, Alberto Esquenazi, Thierry Deltombe, Marjolaine Baude, Alessandro Picelli, Ian Baguley, Stefano Carda, Alessio Baricich, Moon-Suk Bang, Bo Biering-Sørensen, Dirk Dressler, François Genet, Jorge Jacinto, Ryuji Kaji, Patricia Khan, Tiffany Knowlton, Michael C Munin, Preeti Raghavan, Rajiv Reebye, Raymond Rosales, Andrea Santamato, David M Simpson, Areerat Suputtitada, Lynne Turner-Stokes, Jörg Wissel

Published in

American journal of physical medicine & rehabilitation. Jul 02, 2026. Epub Jul 02, 2026.

Abstract

Inconsistent and variably interpreted definitions of spasticity, alongside evolving mechanistic understanding, highlight the need for a clear, clinically relevant consensus definition. An international expert panel used a modified Delphi process to develop a concise, clinically applicable definition that reflects current understanding and supports consistent assessment and management. Participants reviewed existing definitions, completed a pre‑meeting survey, and engaged in structured discussions, with draft definitions iteratively refined through successive rounds of voting to achieve consensus. Key components identified included disordered sensorimotor control, central nervous system involvement, and velocity‑ and length‑dependent resistance to passive stretch, while existing definitions were considered either overly narrow or insufficiently relevant to clinical practice. The consensus definition characterizes spasticity as "A disorder of sensorimotor control resulting from upper motor neuron disease. It is characterized by velocity- and length-dependent involuntary muscle overactivity, which is intermittent or sustained, during passive stretch." This definition integrates contemporary mechanistic concepts with clinical applicability and is intended to improve conceptual clarity, facilitate communication, and promote consistency in diagnosis, measurement, and treatment.

PMID:
42424539
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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