Patient registry of outcomes in spasticity care

Abstract

Objective : To compile data on clinical and patient-reported outcomes related to diagnosis and treatment of spasticity with chemodenervation in stroke and traumatic brain injury patients (TBI). Design : Prospective, multi-center, observational study. Participants : 154 patients to date. Interventions : BoNT-A and phenol injections. Main outcome measures : Demographics, patient history, pain score, patient goals, treatment regimen, satisfaction (from –2 for “very dissatisfied” to 2 for “very satisfied”), goal attainment, and pain follow-up. Results : Data comprised of 75.3% stroke and 26.0% TBI patients. The flexed elbow (26.7%) and equinovarus foot (60.0%) presented the most frequent problems for the upper and lower limbs. Mean dose of BoNT-A injections for the upper limb was 60.9±37.1 units per muscle and mean BoNT-A injections for the lower limb was 109.0±67.2 units per muscle. Mean phenol treatment for the upper limb was 3.5±0.5 cm 3 of 7% and the mean for the lower limb was 4.3±0.8 cm 3 of 7%. Mean Ashworth score improved to 1.1±1.0. Patients reported “very satisfied” (38.9%) and “somewhat satisfied” (38.9%) with their treatment. No related adverse events were reported. Conclusions : This multi-center, descriptive, observational study provides insight into spasticity management relating to etiology, intervention types, muscle selection, patient goals and adverse events.