Goal Attainment after Treatment with Abobotulinumtoxina and a Tailored Home Therapy Programme in Children with Upper Limb Spasticity: Descriptive, Exploratory Analysis of a Large Randomized, Controlled Study

• Published in: Journal of rehabilitation medicine Vol. 54; p. jrm00349
• Main Authors: Carranza-Del Río, Jorge, Dursun, Nigar, Cekmece, Cigdem, Bonikowski, Marcin, Pyrzanowska, Weronika, Dabrowski, Edward, Tilton, Ann, Oleszek, Joyce, Volteau, Magali, Page, Simon, Shierk, Angela, Delgado, Mauricio R
• Format: Journal Article
• Language: English
• Published: Sweden Medical Journals Sweden AB 09-12-2022; Medical Journals Sweden
• Subjects: abobotulinumtoxinA; Botulinum Toxins, Type A - therapeutic use; cerebral palsy; Cerebral Palsy - drug therapy; Child; goal attainment scaling; Humans; Muscle Spasticity - drug therapy; Neuromuscular Agents - therapeutic use; Original Report; physical therapies; Treatment Outcome; Upper Extremity; upper limb
• ISSN: 1651-2081; 1650-1977; 1651-2081
• DOI: 10.2340/jrm.v54.2540

This exploratory analysis of a large, randomized, double-blind study (NCT02106351) describes the effect of treatment with abobotulinumtoxinA followed by a tailored home exercises therapy programme in enabling children with upper limb spasticity due to cerebral palsy to achieve their functional goals using goal attainment scaling (GAS).
Children with cerebral palsy and spasticity in ≥ 1 upper limb received up to 4 injection cycles of abobotulinumtoxinA (2 U/kg (cycle 1 only), 8U/kg and 16U/kg) into the elbow and wrist flexors and other upper limb muscles selected to support individual treatment goals. Children followed a home exercises therapy programme, which included stretches and exercises specifically chosen to facilitate goal achievement and engagement in activities.
For cycle 1, most children had active function goals set as their primary goal (69.7% vs 19.2% passive function goals). GAS T- scores and goal responder rates at week 16 indicated that most types of primary goal were achieved at least as expected during cycle 1 (all groups). Primary goal GAS T-scores were generally maintained for the first 3 abobotulinumtoxinA treatment cycles.
Most children with upper limb spasticity treated with repeat cycles of abobotulinumtoxinA supported by an individualized home exercises therapy programme achieved their functional goals.