Disclosures: Lynne F. Turner Stokes, DM, FRCP: Ipsen (Products/Services: Yes) (Consultant/Advisory Board, Honorarium, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received, Speaker/Honoraria includes speakers bureau, symposia, and expert witness)

Objective: Evaluate whether goal attainment scaling (GAS) is correlated with standardized outcome measures in patients with upper-limb spasticity (ULS).

Design: Prospective, observational study (NCT02454803) examining outcomes from repeated botulinum toxin A (BoNT-A) cycles over 2 years. Setting : International multicenter study. Participants : Adults (≥18 years) with ULS.

Interventions: Patients are treated with BoNT-A per routine practice.

Main Outcome Measures: ULIS-III was the first study to use the ULS Index, an assessment battery that uses a structured approach to GAS (primary outcome) alongside standardised measures, selected according to the goals set. Spearman rank correlations between primary goal attainment and the relevant standardised outcome measures (Numbered Pain Rating Scale [NPRS], Associated Reaction Rating Scale [ARRS], Arm Activity Measure [ArmA] passive and ArmA active) were assessed over the first 6 treatment cycles.

Results: Assessed across the study, pain goals were achieved as expected (cumulated T-score: 50.4) and there was a consistently moderate correlation of goal attainment with reductions in NPRS across the first 6 cycles (correlation coefficients ranged from -0.53 to -0.40, all p < 0.0001). Passive function goals were also achieved as expected (cumulated T-score: 49.8), with statistically significant, weak-moderate correlations with ArmA passive up to Cycle 5 (correlations ranged from -0.42 to -0.22, p < 0.01 for first 5 cycles). Active function goals were achieved slightly less than expected (cumulated-T score: 46.6), with weak-moderate correlations with ArmA active up to cycle 3 (correlations ranged from -0.39 to -0.30, p≤0.01 for first 3 cycles). Finally, involuntary movement goals were achieved as expected (cumulated-T score: 50.5), but goal attainment only weakly correlated with ARRS-total scores during the first 2 cycles (correlations of -0.31 and -0.20, p≤0.05). Conclusions: Goal attainment is generally correlated with the relevant standardized outcome measures. The loss of statistical significance across treatment cycles may reflect the lower numbers of patients in each cycle.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-upper-limb-spasticity-index-correlations-between-goal-attainment-scaling-and-standardized-outcome-measures/