Disclosures: Edward Dabrowski, MD:

Objective: Primary endpoint analysis of this study confirmed abobotulinumtoxinA (8U/kg and 16U/kg) significantly reduced hypertonia versus the 2U/kg low-dose control. We present here further information about goal setting and goal achievement within this study.

Design: Randomized, double-blind study (NCT02106351).Setting : International study in 32 specialist centers.Participants : Children (2-17y) with cerebral palsy and spasticity in ≥1 upper-limb.

Interventions: In the first treatment cycle, 210 children were randomly allocated to treatment with abobotulinumtoxinA 8U/kg, 16U/kg or a low 2U/kg control dose injected into the primary target muscle group (PTMG; elbow or wrist flexors) and additional upper-limb muscles according to presentation. All children participated in an intensive, individualised home-exercise therapy program (HETP) tailored according to treatment goals set at baseline.

Main Outcome Measures: Goal Attainment Scaling (GAS) was included as a secondary measure.

Results: Of the 210 treated children, all but one (99.5%) participated in the HETP between baseline and Week 6. Active rather than passive goals were more commonly selected (active: 69.7%, passive 19.2%). High proportions of children achieved their goals at least as expected (rated as ≥0), with no significant differences in goal achievement between groups. Responder rates for primary goal achievement (2U/kg, 8U/kg, 16U/kg) were 70.6%, 75.8%, 74.3% at Week 6, increasing to 86.4%, 82.1%, 81.2% at Week 16, respectively. Responder rates for individual goals at Week 16 were: Reaching (N&#3f20/23/25 set goals): 100%/91.3%/80.0%; Grasp and Release (N&#3f17/20/14): 70.6%/75.0%/78.6%; Involving the Arm More (N&#3f31/28/31): 77.4%/89.3%/80.6%; Using Limb as Helping Hand (N&#3f16/18/18): 87.5%/61.1%/88.9%; Dressing (N&#3f12/14/7): 66.7%/85.7%/71.4%; Range of Movement (N&#3f8/16/7): 87.5%/68.8%/85.7%; Donning/Tolerating Splints (N&#3f2/4/3): 50.0%, 75.0%, 100%; Ease of Care (N&#3f2/1/1): 100%/100%/0; Hygiene (N&#3f0/1/4): -/100%/75.0%.Conclusions: Treatment with abobotulinumtoxinA plus a HETP was associated with high levels of goal achievement. In this population of children with cerebral palsy, active goals were more commonly selected than passive goals.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/goal-attainment-following-treatment-with-abobotulinumtoxina-and-intensive-home-therapy-in-children-with-upper-limb-spasticity/