TY - JOUR
T1 - Assessing the effectiveness of upper-limb spasticity management using a structured approach to goal-setting and outcome measurement
T2 - First cycle results from the ulis-III study
AU - Turner-Stokes, Lynne
AU - Jacinto, Jorge
AU - Fheodoroff, Klemens
AU - Brashear, Allison
AU - Maisonobe, Pascal
AU - Lysandropoulos, Andreas
AU - Ashford, Stephen
AU - Baguley, Ian
AU - Aggarwal, Arun
AU - Olver, John
AU - Estell, John
AU - Faux, Steven
AU - Luk, Edwin
AU - Kotschet, Katya
AU - Hughes, Andrew
AU - Nunan, Rachael
AU - Haslinger, Bernhard
AU - Baum, Petra
AU - Mobius, Cornelia
AU - Fietzek, Urban
AU - Chi Wang, Ip
AU - Chung, Tae Mo
AU - Chueire, Régina Helena
AU - Moro, Carla Heloisa Cabral
AU - Schnitzler, Alexis
AU - Delleci, Claire
AU - Ferrapie, Anne Laure
AU - Isner-Horobeti, Marie Eve
AU - Perennou, Dominic
AU - Leung, Ching Man
AU - Cosma, Michela
AU - Caltagirone, Carlo
AU - Diverio, Manuela
AU - Girlanda, Paolo
AU - Ianeri, Giancarlo
AU - Millevolte, Marzia
AU - Molteni, Franco
AU - Franco, Jorge Hernandez
AU - Hernandez, Juan Francisco Gomez
AU - Aguilar, Sandra Quinones
AU - de la Lanza Andrade, Laura Patricia
AU - Rosales, Raymond
AU - Flordelis, Jeanne
AU - Koziorowski, Dariusz
AU - Potulska, Anna
AU - Rudzinska, Monika
AU - Afonso, Eduarda
AU - Duarte, Ana Rolo
AU - Khatkova, Svetlana
AU - Korenko, Alexey
AU - Khasanova, Dina
AU - Okhabov, Dmitry
AU - Arefyeva, Elena
AU - Karpov, Denis
AU - Korolev, Andrey
AU - Lee, Yi Chung
AU - Tsai, Sen Wei
AU - Tate, Jessica
AU - Davis, Thomas L.
AU - Marciniak, Cynthia
AU - Patel, Atul
N1 - Funding Information:
Person-centred goal attainment Supported by standardised assessment tools
Funding Information:
The authors thank all the investigators and patients who participated in this trial. We also thank Anita Chadha-Patel, PhD, of ACP Clinical Communications Ltd (Hertfordshire, UK) for providing medical writing support, which was funded by Ipsen (Paris, France) in accordance with Good Publication Practice guidelines. Financial support for manuscript preparation was also provided through the Northwick Park Charitable Funds. Funding. This work was supported by Ipsen Pharma.
Publisher Copyright:
© 2021 Foundation for Rehabilitation Information. All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Objective: To describe the utility of a structured approach to assessing effectiveness following injection with botulinum toxin-A alongside physical therapies, within the first cycle of the Upper Limb International Spasticity-III (ULIS-III) study. Methods: ULIS-III (registered at clinicaltrials.gov as NCT02454803) is a large international, observational, longitudinal study of adults treated for upper-limb spasticity. It introduces novel methods for the structured evaluation of person-centred goal attainment alongside targeted standardized outcome measures: the Upper limb Spasticity Index, and the Upper Limb Spasticity Therapy Recording Schedule. Results: A total of 953/1,004 enrolled patients (95%) completed cycle 1. Mean overall goal attainment scaling (GAS) T scores were 49.8 (95% confidence interval 49.2-50.3; 67.1% of patients met their primary goal, with highest achievement rates for goals related to involuntary movement, (75.6%) and range of movement (74.4%). Standardized measures of spasticity, pain, involuntary movements, active and passive function, all improved significantly over the treatment cycle. Overall, 59.7% of patients saw a therapist following botulinum toxin-A injection. Interventions varied, as expected, with the set treatment goals. After controlling for concomitant therapies using the upper limb spasticity therapy recording schedule, significant differences in injection intervals (p< 0.001) were seen between the commercially-available botulinum toxin-A agents. Conclusion: The results of this study confirm the utility of the Upper Limb Spasticity Index and Upper Limb Spasticity Therapy Recording Schedule as a structured approach to capturing goal-setting, therapy inputs and outcomes assessment.
AB - Objective: To describe the utility of a structured approach to assessing effectiveness following injection with botulinum toxin-A alongside physical therapies, within the first cycle of the Upper Limb International Spasticity-III (ULIS-III) study. Methods: ULIS-III (registered at clinicaltrials.gov as NCT02454803) is a large international, observational, longitudinal study of adults treated for upper-limb spasticity. It introduces novel methods for the structured evaluation of person-centred goal attainment alongside targeted standardized outcome measures: the Upper limb Spasticity Index, and the Upper Limb Spasticity Therapy Recording Schedule. Results: A total of 953/1,004 enrolled patients (95%) completed cycle 1. Mean overall goal attainment scaling (GAS) T scores were 49.8 (95% confidence interval 49.2-50.3; 67.1% of patients met their primary goal, with highest achievement rates for goals related to involuntary movement, (75.6%) and range of movement (74.4%). Standardized measures of spasticity, pain, involuntary movements, active and passive function, all improved significantly over the treatment cycle. Overall, 59.7% of patients saw a therapist following botulinum toxin-A injection. Interventions varied, as expected, with the set treatment goals. After controlling for concomitant therapies using the upper limb spasticity therapy recording schedule, significant differences in injection intervals (p< 0.001) were seen between the commercially-available botulinum toxin-A agents. Conclusion: The results of this study confirm the utility of the Upper Limb Spasticity Index and Upper Limb Spasticity Therapy Recording Schedule as a structured approach to capturing goal-setting, therapy inputs and outcomes assessment.
KW - Botulinum toxin-A
KW - Goal attainment scaling
KW - Physical therapy
KW - Post-stroke spasticity
KW - Stroke rehabilitation
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U2 - 10.2340/16501977-2770
DO - 10.2340/16501977-2770
M3 - Article
C2 - 33206198
AN - SCOPUS:85099427933
VL - 53
JO - Journal of Rehabilitation Medicine
JF - Journal of Rehabilitation Medicine
SN - 1650-1977
IS - 1
M1 - jrm00133
ER -