Poster 54: Patient Registry of Outcomes in Spasticity Care (PROS Care)

Objective: To compile data characterizing clinical and patient-reported outcomes associated with the diagnosis and treatment of spasticity with chemodenervation in stroke and traumatic brain injury (TBI) patients. Design: Prospective, multi-center, observational study. Setting: Multi-center. Participants: 154 patients to date. Interventions: Botulinum toxin type A (BTX) and phenol injections. Main Outcome Measures: Demographics, patient history, pain score (visual analog scale, 0–10), patient goals, treatment, and satisfaction (−2 [very dissatisfied] to 2 [very satisfied]), goal attainment (−2 [lost a lot of ground towards goal] to 2 [complete achievement of goal]), and pain follow-up. Results: Data comprised of 75.3% stroke and 26% TBI patients. The flexed elbow was the most frequent presenting problem (26.7%) for the upper limb and the equinovarus foot (60.0%) for the lower limb. The most frequently injected muscle for the flexed elbow was the biceps (10.8%). Medial/lateral gastrocnemius (17%) were most frequently injected muscles for the equinovarus foot. Average dose of BTX injections (n=590) for the upper limb was 60.9±37.1 units per muscle and average BTX injections (n=217) for the lower limb was 109.0±67.2 units per muscle. BTX injections ranged from 5 to 250 units for the upper limb and 25 to 400 units for the lower limb. Average phenol treatment for the upper limb was 3.5±0.5cc of 7% and the average for the lower limb was 4.3±0.8cc of 7%. Mean Ashworth score (n=95) improved 1.1±1.0. Patients reported being “very satisfied” (38.9%) and “somewhat satisfied” (38.9%) with their treatment. No related adverse effects were reported. Conclusions: This is the first, multi-center, descriptive, observational study providing insight into spasticity management relating to etiology, degree of spasticity, intervention types, muscle selection, delivery methods, patient goals, and adverse effects.