Therapy influences goal attainment following botulinum neurotoxin injection for focal spasticity in adults with neurological conditions

Elizabeth Jane Moore, John Olver, Adam Leigh Bryant, Dean Philip McKenzie, Gavin Williams

Research output: Contribution to journalArticleResearchpeer-review


Objective: To determine whether therapy influenced goal attainment following botulinum toxin (BoNT-A) injection for focal spasticity in adults with neurological conditions. Methods: A prospective observational cohort study conducted in a large metropolitan spasticity clinic on adults with focal spasticity of any origin. Participants were provided with a therapy programme, designed to maximise therapeutic outcome. The primary outcome measure was Goal Attainment Scaling. To measure adherence, participants completed a therapy-recording tool each day. Goal attainment, and the rate of adherence to the therapy programme, was evaluated after 10 weeks. Results: Active indications for BoNT-A treatment made up the majority of the goals (80.30%). Goals were achieved in 43/76 cases (56.60%; 95% CI = 42.40 to 69.80%). Therapy adherence was associated with significantly greater goal attainment (OR = 1.02, p = 0.03, 95% CI = 1.00 to 1.04). Greater adherence to therapy increased the odds of goal achievement for active indications but not for passive indications, suggesting a possible statistical interaction between the indication for injection and adherence to therapy (p < 0.01). Conclusion: Therapy adherence was associated with greater goal attainment. Active indications for BoNT-A were more reliant on adherence to prescribed therapy programmes than passive indications, although further investigation is required.

Original languageEnglish
Pages (from-to)948-956
Number of pages9
JournalBrain Injury
Issue number7
Publication statusPublished - 7 Jun 2018


  • botulinum toxin
  • goal attainment
  • rehabilitation
  • Spasticity
  • therapy

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