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Goal-Setting in Multiple Sclerosis-Related Spasticity Treated with Botulinum Toxin: The GASEPTOX Study.

Ines Baccouche1,2, Djamel Bensmail1,2, Emilie Leblong3

  • 1Department of Physical Medicine and Rehabilitation, Raymond-Poincaré University Hospital, AP-HP, 104 Blvd Raymond Poincaré, 92380 Garches, France.

Toxins
|September 22, 2022
PubMed
Summary

Botulinum toxin injections effectively manage multiple sclerosis spasticity by achieving patient-set goals, particularly for lower limb and mobility impairments. This treatment offers functional improvements in daily activities for many individuals with MS.

Keywords:
botulinum toxindisabilitygoal attainment scalelocomotionmultiple sclerosisspasticity

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Area of Science:

  • Neurology
  • Rehabilitation Medicine

Background:

  • Spasticity is a primary disabling symptom in multiple sclerosis (MS).
  • Botulinum toxin injection (BTI) is a standard treatment for focal spasticity.
  • Evidence for functional improvement from BTI in MS spasticity is limited.

Purpose of the Study:

  • To outline common goal-setting practices for BTI in MS patients.
  • To evaluate goal attainment using Goal Attainment Scaling (GAS) post-BTI.
  • To assess the effectiveness of BTI in managing MS-related spasticity.

Main Methods:

  • A one-year, multi-center retrospective observational study.
  • Patients and physicians collaboratively set up to three goals per BTI session.
  • Goal achievement was assessed using GAS 4-to-6 weeks after injection.

Main Results:

  • 125 BTI sessions were analyzed, with goals focused on lower limb impairments (89.1%) and locomotion.
  • Upper limb goals accounted for 10.9% of objectives.
  • High overall goal achievement rate of 85.77% was observed, especially for gait and mobility goals.

Conclusions:

  • BTI is effective in achieving patient-centered goals for MS spasticity.
  • Goal-setting for BTI in MS should prioritize lower limb and mobility functions.
  • This study provides insights into practical and achievable goals for BTI in MS spasticity management.