PTOTCohortJournal of rehabilitation medicine2026

Evolution of goal setting and attainment over repeated cycles of botulinum toxin A for upper limb spasticity in real-life clinical practice: longitudinal analyses from the observational ULIS-III cohort study.

Lynne Turner-Stokes, Klemens Fheodoroff, Jorge Jacinto and 4 others

PMID 42047510

WHAT IT FOUND

In patients receiving repeated botulinum toxin A for upper limb spasticity, goal attainment remained stable over four cycles.

Using injection guidance in at least three cycles nearly doubled the odds of meeting goals compared with fewer guided injections.

Key findings

01Mean GAS T-scores remained around 50 across four treatment cycles, indicating goals were consistently achieved as expected.

02Patients using injection guidance in at least three of four cycles were 1.92 times more likely to achieve a GAS T-score of 50 or higher than those with two or fewer guided cycles.

03Patients requiring 24.5 or more hours of therapy per week were significantly less likely to achieve treatment goals than those requiring less than 3 hours.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study had no control group, so it cannot prove that botulinum toxin A caused the improvements. Data were missing for some patients, and no imputations were made. The analysis was post-hoc and did not adjust for multiple comparisons. Most patients were treated with one specific formulation of botulinum toxin A, which may introduce selection bias. The study did not compare different injection guidance techniques against each other.

Declared interests

The study was sponsored by Ipsen, a manufacturer of botulinum toxin A products.

The easy way to misread this

Do not assume that high therapy hours cause poor outcomes. The study suggests that patients needing over 24.5 hours of therapy per week were less likely to meet goals because they had more severe conditions, not because the therapy was ineffective.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →