Article

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.

Langue : ANGLAIS