Development of a framework to define the functional goals and outcomes of botulinum toxin A spasticity treatment relevant to the child and family living with cerebral palsy using the International Classification of Functioning, Disability and Health for Children and Youth.
OBJECTIVE
To define a sub-set of functional goals and outcomes relevant to children and families living with cerebral palsy following treatment with botulinum toxin type A using the International Classification of Functioning, Disability and Health for Children and Youth.


METHODS
We identified treatment goals and treatment outcomes from medical case records in 2102 assessments of 239 children with cerebral palsy treated with botulinum toxin between 1994 and 2009. Goals were set through assessment and discussion by experienced clinicians, therapists, parents and children.


RESULTS
There were 61 separate goals, mapping to 40 categories, falling mostly within Body Functions: b710 Mobility of joint functions (414 times); b770 Gait pattern functions (374 times); b7351 Tone of muscles of one limb (117 times). A total of 93 separate treatment outcomes were identified, mapping to 51 categories. Two of the 3 most common outcomes correspond to the 2 most common goals (gait pattern and mobility of joint functions).


CONCLUSIONS
The International Classification of Functioning, Disability and Health for Children and Youth provides a useful framework to categorize the reasons for using botulinum toxin in children and focuses the clinical consultation not only on impairments but also functional outcomes.
Academic Department of Rehabilitation Medicine, The University of Leeds, UK. n.preston@leeds.ac.uk
Nick
N
Preston
Michael
M
Clarke
Bipin
B
Bhakta
D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology; D006040:Goals; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D010290:Parents; D016059:Range of Motion, Articular / Q000502:physiology; D016138:Walking / Q000502:physiology; D055815:Young Adult
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A