Article

Purpose: Goal Attainment Scaling (GAS) is used to assess functional gains in
response to treatment. Specific characteristics of the functional goals set by
individuals receiving botulinum toxin type A (BoNTA) injections for spasticity
management are unknown.
The primary objectives of this study were to describe the
characteristics of the goals set by patients before receiving BoNTA injections
using the International Classification of Functioning, Disability and Health
(ICF) and to determine whether the pattern of spasticity distribution affected
the goals set. Methods: A cross-sectional retrospective chart review was carried
out in an outpatient spasticity-management clinic in Toronto. A total of 176
patients with a variety of neurological lesions attended the clinic to receive
BoNTA injections and completed GAS from December 2012 to December 2013. The main
outcome measures were the characteristics of the goals set by the participants on
the basis of ICF categories (body functions and structures, activity and
participation) and the spasticity distribution using Modified Ashworth Scale
scores. Results: Of the patients, 73% set activity and participation goals, and
27% set body functions and structures goals (p<0.05). In the activity and
participation category, 30% of patients set moving and walking goals, 28% set
self-care and dressing goals, and 12% set changing and maintaining body position
goals. In the body functions and structures category, 18% set neuromuscular and
movement-related goals, and 8% set pain goals. The ICF goal categories were not
related to the patterns of spasticity (upper limb vs. lower limb or unilateral
vs. bilateral spasticity) or type of upper motor neuron (UMN) lesion (p>0.05).
Conclusion: Our results show that patients receiving BoNTA treatment set a higher
percentage of activity and participation goals than body functions and structures
goals. Goal classification was not affected by type of spasticity distribution or
type of UMN disorder.

Langue : ANGLAIS