Международный журнал физической медицины и реабилитации
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Retrospective Analysis of Goal Assessment for Conservative Treatment and Surgical Intervention for Spasticity of Upper and Lower Limbs in an Interdisciplinary Neuro-Orthopedic Spasticity Clinic

Mézier J, Zambelli PY, Bonnard Ch, Raffoul W, Vuadens Ph and Diserens K

Background and Objective: This retrospective study analyses the goal assessment of the treatment of spasticity. The outcome was to compare the efficiency of treatments in term of goal from the International Classification of Functioning, Disability and Health (ICF). Methods: A database was created from the patients' medical files. The efficiency of treatment was then evaluated using the improvement in the sub-goals of the ICF: pain (B280-B289), function of the joints and bones (B710-B729), improvement of mobility (D450-DN83) and personal maintenance (D510-D599). The results are discussed after a literature review. Results: The botulinum toxin injection was more common than orthopedic procedures. Orthopedic procedures showed a tendency to be more efficient regarding the improvement in ICF objectives. Conclusions: This study was unable to prove a statistically significant difference between botulinum toxin and orthopedic procedure regarding ICF objectives due to the number of subjects being too small. But it showed that 83.4% of patients were treated by botulinum toxin before surgery and only operated in the case of failed goalachievement. The surgery then enabled the goal to be achieved. This systematic goal assessment is necessary in order to understand better the efficiency of the management of spasticity treatment methods.