Disclosures: Lynne Turner-Stokes, DM FRCP: Ipsen PLC (Products/Services: No) (Honorarium, Speaker/Honoraria includes speakers bureau, symposia, and expert witness)Kings’s College London (Products/Services: No) (Employment)London NorthWest University Healthcare NHS Trust (Products/Services: Yes) (Employment)

Objective: Goal Attainment Scaling (GAS) is used to assess the effectiveness of rehabilitation in the areas that matter most to patients and caregivers. In this analysis of the ULIS-III study, we evaluate longitudinal goal achievement in those patients who chose a goal related to active function.

Design: Prospective, observational study (NCT02454803) examining outcomes from repeated BoNT-A cycles over 2 years.Setting : International study in 53 secondary care centers (14 countries).Participants : Adults (≥18 years) with upper-limb spasticity of various etiology.

Interventions: Patients are treated with BoNT-A per routine practice, including usual concomitant therapies (physical interventions and systemic antispasmodic and pain agents).

Main Outcome Measures: ULIS-III was the first study to use the Upper Limb Spasticity Index, an assessment battery including a structured approach to GAS alongside standardized measures, including the Arm Activity Measure (ArmA).

Results: Of the 1004 participants enrolled, 285 (28%) set a goal related to active function during the study. The mean [95%CI] cumulative GAS-T score for active function was 46.6[45.8, 47.5] indicating lower than expected active function goal attainment. However, across the study, 71.4% of patients achieved their primary goals related to active function. By cycle analysis (primary + secondary goals) showed there was a progressive increase in the rates of goal achievement, from 48.2% achievement in Cycle 1 (n=253) to 57.7% (n=168), 68.0% (n=153), 63.9% (n=108), 65.8% (n=76), 68.3% (n=41) and 76.0% (n=25) in Cycles 2 through 7, respectively. Active function as assessed by ArmA active function scores (assessed in patients with active function goals) also showed significant improvements (mean [95%CI] reduction of -3.2[-4.3, -2.2] points, p < 0.0001 vs. baseline).Conclusions: In the early treatment cycles, goal achievement was lower than expected for active function, suggesting that goal setting may have been over-ambitious. However, from Cycle 4 onwards, rates of achievement improved, possibly as both patients and clinicians learned what outcomes could reasonably be expected from their treatment.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/active-function-goal-achievement-with-integrated-arm-spasticity-management-including-botulinum-toxin-a/