title: Common goal areas in the treatment of upper limb spasticity: a multicentre analysis.
abstract: OBJECTIVE
  We aimed to develop a goal classification of individualised goals for spasticity treatment incorporating botulinum toxin intervention for upper limb spasticity to under-pin a more structured approach to future goal setting.
  
  
  METHODS
  Individualised goals for spasticity treatment incorporating botulinum toxin intervention for upper limb spasticity (n=696) were analysed initially from four studies published in 2008-2012, spanning a total of 18 centres (12 in the UK and 6 in Australia). Goals were categorised and mapped onto the closest matching domains of the WHO International Classification of Functioning. Confirmatory analysis included a further 927 goals from a large international cohort study spanning 22 countries published in 2013.
  
  
  RESULTS
  Goal categories could be assigned into two domains, each subdivided into three key goal areas: Domain 1: symptoms/impairment n=322 (46%): a. pain/discomfort n=78 (11%), b. involuntary movements n=75 (11%), c. range of movement/contracture prevention n=162 (23%). Domain 2: Activities/function n=374 (54%): a. passive function (ease of caring for the affected limb) n=242 (35%), b active function (using the affected limb in active tasks) n=84 (12%), c. mobility n=11 (2%).Over 99% of the goals from the large international cohort fell into the same six areas, confirming the international applicability of the classification.
  
  
  CONCLUSIONS
  Goals for management of upper limb spasticity, in worldwide clinical practice, fall into six main goal areas.
authors.affiliation: Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, UK King's College London, Faculty of Life Science and Medicine, Department of Palliative Care, Policy and Rehabilitation, UK Stephen.Ashford@nhs.net.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ashford
authors.affiliation: Department of Neurorehabilitation, Gailtal-Klinik, Hermagor, Austria.
authors.forename: Klemens
authors.initials: K
authors.lastname: Fheodoroff
authors.affiliation: Centro de Medicina de Reabilitaçãode Alcoitão, Serviço de Reabilitação de Adultos 3, Estoril, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Jacinto
authors.affiliation: Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, UK King's College London, Faculty of Life Science and Medicine, Department of Palliative Care, Policy and Rehabilitation, UK.
authors.forename: Lynne
authors.initials: L
authors.lastname: Turner-Stokes
mesh_terms: D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D015337:Multicenter Studies as Topic; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009498:Neurotoxins / Q000627:therapeutic use; D010347:Patient Care Planning / Q000458:organization & administration* / Q000592:standards; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology*
chemical_list: D009498:Neurotoxins; D001905:Botulinum Toxins
keywords: Goal-setting; activities; arm; botulinum toxin; muscle spasticity