Self-Selected Goal Attainment Following Botulinum Toxin A Injections: Upper Limb Performance Assessment.

Area of Science:

• Neurorehabilitation
• Clinical Outcome Measurement
• Motor Control

Background:

• Assessing functional upper limb (UL) outcomes post-Botulinum Toxin A (BTX-A) for spasticity presents measurement challenges.
• Existing measures often fail to capture personally meaningful UL performance in real-world contexts.

Purpose of the Study:

• To evaluate the Upper Limb Performance Assessment (ULPA) as a measure of motor function in adults with UL spasticity post-acquired brain injury.
• To determine if the ULPA can detect changes in UL functional use for self-selected goals following BTX-A treatment.

Main Methods:

• A multicentre, pre/post observational study design was employed.
• The ULPA, an observer-rated measure, assessed patient-centered, real-world UL tasks in adults with acquired brain injury.
• Data were collected before and after BTX-A injections.

Main Results:

• The ULPA demonstrated sensitivity in detecting changes in UL functional use for self-selected goals.
• Improvements were observed in Task Performance Mastery and reductions in Excessive and Missing task-specific movements.
• ULPA sub-measures showed correlation with Goal Attainment Scaling, indicating alignment with patient goals.

Conclusions:

• The Upper Limb Performance Assessment (ULPA) is a skilled clinical observation tool capable of detecting functional UL performance changes after BTX-A in adults with acquired brain injury.
• The ULPA provides a reliable method for assessing meaningful UL improvements in this patient population.