Session Information
Date: Tuesday, September 24, 2019
Session Title: Spasticity
Session Time: 1:45pm-3:15pm
Location: Les Muses Terrace, Level 3
Objective: The Upper Limb International Spasticity (ULIS) programme is a series of observational cohort studies across >30 countries. This analysis explores changes in goal setting and achievement between the second and third stages of the programme (ULIS-II and ULIS-III studies) to explore how the process of goal setting has evolved in long-term spasticity management.
Background: The ULIS programme has been ongoing since 2008 and its focus on systematic evaluation of individual goal achievement has helped lead to important changes in clinical practice. Throughout the programme we have progressively refined the approach to outcome measurement.
Method: ULIS-II (NCT01020500) followed 456 post-stroke patients over a single BoNT-A cycle. ULIS-III (NCT02454803) examined outcomes from repeated BoNT-A cycles over 2 years in 1004 patients (various aetiologies). Each phase of the programme is supported by investigator training. We present ULIS-II data for all patients and preliminary ULIS-III data for the first cycle in 807 patients.
Results: Study comparisons showed progress in the types of goals set. Whereas the frequency of primary goals increased for pain (from 13.4% in ULIS-II to 25.3% in ULIS-III), reduction of involuntary movement (from 9.0% to 13.3%) and passive function (from 28.9 to 30.7%), rates of goal setting decreased for active function (from 22.8% to 15.0%) and range of movement (from 23.0% to 13.9%). Patterns of injection evolved in line with goal setting. For example, the rate of shoulder injections increased from 32.0% to 39.4%, mainly reflecting the increased recognition of pain as a primary goal. Overall rates of goal achievement fell from 79.6% in ULIS-II to 69.4% in ULIS-III, reflecting a tighter definition of goals.
Conclusion: Over the past decade, the ULIS programme provides a description of the evolution of routine spasticity management as clinicians develop how they support their patients setting relevant and achievable treatment goals.
To cite this abstract in AMA style:
K. Fheodoroff, S. Ashford, J. Jacinto, A. Brashear, P. Maisonobe, A. Lysandropoulos, L. Turner-Stokes. Goal setting for botulinum toxin injections: Impact of the Upper Limb International Spasticity (ULIS) programme [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/goal-setting-for-botulinum-toxin-injections-impact-of-the-upper-limb-international-spasticity-ulis-programme/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/goal-setting-for-botulinum-toxin-injections-impact-of-the-upper-limb-international-spasticity-ulis-programme/