Abstract Details

Title Integrated Upper Limb Spasticity Management Including Botulinum Toxin A on Patient-centred Goal Attainment: The ULIS-III Study

Topic Neuro-rehabilitation

Presentation(s) S42 - Neuro-rehabilitation (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Objective Describe data on real-life clinical practice and goal attainment for integrated management of upper limb spasticity (ULS), including repeated botulinum toxin-A (BoNT-A) injections.

Background ULIS-III was a prospective, observational, longitudinal (2-year) cohort study (NCT02454803) of integrated ULS management, including BoNT-A, starting January 2015 and completing December 2019.

Design/Methods Eligible participants were ≥18 years with ULS in whom a decision had already been made to inject BoNT-A. The study was the first to use the Upper Limb Spasticity Index (ULSI), an assessment battery including a structured approach to goal attainment scaling (GAS) alongside a set of standardized measures. Participants continued with their usual concomitant therapies, which were recorded in the Upper Limb Focal Spasticity Therapy Recording Schedule (ULSTR) to document the number/duration/type of therapies related to specific goals.

Results 1004 participants (14 countries) were enrolled; we report interim data for Treatment Cycle 1 (n=807). A median of five muscles were injected (range: 1−15), most commonly in the forearm. 60.4% of participants saw a therapist after BoNT-A treatment: the most frequent therapy interventions were passive stretch (69.4%), splinting (25.7%) and strength-training (24.8%). Mean [95%CI] overall GAS T-scores were 49.9 [49.4, 50.5] at end of cycle; 69.4% of participants met their first primary treatment goal, with highest rates of achievement for primary goals related to passive (75.0%) vs. active function (52.1%). Standardised measures of spasticity, pain, involuntary movements, active and passive function all improved over the treatment cycle.

Conclusions The ULIS-III is the first study to use the ULSI in the assessment of BoNT-A effectiveness for upper-limb spasticity. Data captured in the ULSTR describe how therapies are used alongside BoNT-A treatment. First cycle data indicate that nearly 70% patients achieved their primary goal.

Authors/Disclosures
PRESENTER	No disclosure on file
Stephen Ashford	Stephen Ashford has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Stephen Ashford has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ipsen. Stephen Ashford has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Ipsen. The institution of Stephen Ashford has received research support from Ipsen.
	No disclosure on file
Jorge Jacinto	Jorge Jacinto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merz, Ipsen, Allergan. Jorge Jacinto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merz, Allergan, Ipsen.
Allison Brashear, MD, MBA, FAAN (Univeristy of Buffalo)	Dr. Brashear has received personal compensation for serving as an employee of McKnight Brain Res Found. Dr. Brashear has received personal compensation for serving as an employee of American Board of Psychiatry and Neurology. Dr. Brashear has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for ABPN. Dr. Brashear has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for McKnight Brain Research Foundation i. Dr. Brashear has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Care Directions- start up . Dr. Brashear has stock in Caredirections . The institution of Dr. Brashear has received research support from NINDS. Dr. Brashear has received publishing royalties from a publication relating to health care. Dr. Brashear has received personal compensation in the range of $500-$4,999 for serving as a Special government employee and study section reviewer with NIH. Dr. Brashear has received personal compensation in the range of $0-$499 for serving as a Adminstrative board -travel reimbursement with AAMC.
Pascal Maisonobe	Pascal Maisonobe has received personal compensation for serving as an employee of ipsen pharma. Pascal Maisonobe has received personal compensation for serving as an employee of Ipsen.
Andreas Lysandropoulos (Parexel)	Andreas Lysandropoulos has nothing to disclose.

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