OBJECTIVES: Evaluate upper-limb goal attainment following botulinum toxin-A, map goals to the International Classification of Functioning, Disability and Health (ICF) and explore associations between client goals, clinical indicators of spasticity and the Botulinum Toxin-A injection strategy adopted by the treating physician. DESIGN: Pre-test/post-test. PARTICIPANTS: Twenty-eight community-dwelling adults with acquired brain injury. METHODS: Goal attainment was measured using the Goal Attainment Scale (GAS) 4 weeks post-injection. Goals were linked to the ICF. Clinical measures including the Modified Ashworth Scale (MAS), Tardieu Spasticity Angle (TSA) and Action Research Arm Test (ARAT) were collected pre-injection for determining association with injection strategy. RESULTS: Goals represented the ICF domains of Body Structure/Function and Activity/Participation. Approximately half the goals were achieved 4 weeks post-injection and GAS T-scores improved significantly. Activity/Participation goals were equally likely to be achieved as Body Structure/Function goals. Pre-injection ARAT scores were correlated with GAS change, whereas MAS and TSA scores were not. TSA was a stronger indicator of muscle selection for botulinum toxin-A injections than MAS. Goals were directly associated with botulinum toxin-A injections for distal hand function, but not for proximal upper-limb function. CONCLUSION: Goal setting and review provides a clinically useful process for measuring upper-limb botulinum toxin-A outcomes.
OBJECTIVES: Evaluate upper-limb goal attainment following botulinum toxin-A, map goals to the International Classification of Functioning, Disability and Health (ICF) and explore associations between client goals, clinical indicators of spasticity and the Botulinum Toxin-A injection strategy adopted by the treating physician. DESIGN: Pre-test/post-test. PARTICIPANTS: Twenty-eight community-dwelling adults with acquired brain injury. METHODS: Goal attainment was measured using the Goal Attainment Scale (GAS) 4 weeks post-injection. Goals were linked to the ICF. Clinical measures including the Modified Ashworth Scale (MAS), Tardieu Spasticity Angle (TSA) and Action Research Arm Test (ARAT) were collected pre-injection for determining association with injection strategy. RESULTS: Goals represented the ICF domains of Body Structure/Function and Activity/Participation. Approximately half the goals were achieved 4 weeks post-injection and GAS T-scores improved significantly. Activity/Participation goals were equally likely to be achieved as Body Structure/Function goals. Pre-injection ARAT scores were correlated with GAS change, whereas MAS and TSA scores were not. TSA was a stronger indicator of muscle selection for botulinum toxin-A injections than MAS. Goals were directly associated with botulinum toxin-A injections for distal hand function, but not for proximal upper-limb function. CONCLUSION: Goal setting and review provides a clinically useful process for measuring upper-limb botulinum toxin-A outcomes.
Authors: Kevin Choi; Jaclyn Peters; Andrew Tri; Elizabeth Chapman; Ayako Sasaki; Farooq Ismail; Chris Boulias; Shannon Reid; Chetan P Phadke Journal: Physiother Can Date: 2017 Impact factor: 1.037
Authors: Charlotte M W Gaasterland; Marijke C Jansen-van der Weide; Stephanie S Weinreich; Johanna H van der Lee Journal: BMC Med Res Methodol Date: 2016-08-17 Impact factor: 4.615
Authors: Tiina Rekand; Bo Biering-Sörensen; Jun He; Ole Jakob Vilholm; Peter Brøgger Christensen; Trandur Ulfarsson; Roger Belusa; Torbjörn Ström; Peter Myrenfors; Pascal Maisonobe; Torben Dalager Journal: BMJ Open Date: 2019-05-05 Impact factor: 2.692