Self-Selected Goal Attainment Following Botulinum Toxin A Injections: Upper Limb Performance Assessment

Challenges remain in measuring functional upper limb (UL) outcomes following Botulinum Toxin A (BTX-A) injections for muscle spasticity. Few measures exist to evaluate personally meaningful UL performance. The Upper Limb Performance Assessment (ULPA) is an observer-rated measure using patient-centred and selected tasks in real-world conditions. This multicentre, pre/post observational study examined the ULPA's ability to measure motor function of adults with UL spasticity following acquired brain injury on self-selected goals. The ULPA detected change in UL functional use for self-selected goals, with improved Task Performance Mastery and reduced Excessive and Missing task-specific movements. This corresponded with an increased number of Expected movements for the task. ULPA sub-measures correlated with goal attainment as measured by Goal Attainment Scaling. The ULPA, a skilled clinical observation measure, can detect change in functional UL performance following BTX-A injection in adults with acquired brain injury.