CLINICAL PRESENTATION OF PATIENTS WITH LOWER LIMB SPASTICITY UNDERGOING ROUTINE TREATMENT WITH BOTULINUM TOXIN: BASELINE FINDINGS FROM AN INTERNATIONAL OBSERVATIONAL STUDY

Abstract

Objective: Describe how people with lower limb spasticity present for treatment in routine clinical practice. Methods: Prospective, observational study (Clini-caltrials.gov: NCT04050527) of ambulatory adult patients (≥ 18 years) with unilateral lower limb spasticity (able to take ≥ 5 steps with or without assistance) presenting for routine spasticity management, including treatment with abobotu-linumtoxinA. Results: The study population included 430 adults with lower limb spasticity. Despite their relatively young age (mean ± standard deviation 53.7 ± 13.9 years), only 20% of patients were employed. Most patients had an acquired brain injury due to cere-brovascular disease; 84.1% reported having concomitant upper limb spasticity. Using the Leg Activity Measure, most patients reported no or only mild difficulties in performing hygiene/positioning tasks, while 80.7% had at least mild difficulty with indoor ambulation and 90.5% had at least mild difficulty with walking outdoors. Sensory, communication and/or cognitive impairments were also common. At the first treatment cycle, 50.7% of patients set active function primary goals, including locomotion transferring or standing. Conclusion: These observations highlight the com-plexity of presentation that must be considered when setting treatment goals for lower limb spas-ticity and emphasize the types of impairment and activity (functional) limitations that treating teams may expect to encounter in their patients and should cover in their initial and follow-up assessments.