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Poster 77: Impact of Dynamic Body‐Weight Support on Inpatient Rehabilitation Outcomes in Non‐Traumatic Spinal Cord Injury: Preliminary Findings of an Ongoing Study
Author(s) -
Huber Justin P.,
Sawaki Lumy
Publication year - 2018
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2018.08.103
Subject(s) - citation , spinal cord injury , rehabilitation , medicine , library science , gerontology , physical therapy , psychiatry , spinal cord , computer science
Disclosures: Alberto Esquenazi: Research Grants Allergan, Ipsen Objective: Examine patterns of onabotulinumtoxinA treatment in patients with lower limb spasticity following 2 years of observation. Design: Multicenter, prospective, observational study (NCT01930786). Setting: International, clinical sites. Participants: Adults with focal spasticity across multiple etiologies. Interventions: OnabotulinumtoxinA administered at physician’s discretion. Main Outcome Measures: OnabotulinumtoxinA utilization patterns, effectiveness, and safety. Results: Patients (N1⁄4731) were on average 53.6 years of age (18.5-93.2 years), 52% female (n1⁄4380), and predominantly Caucasian (n1⁄4562, 77%). Stroke was the most frequently reported etiology, at baseline (n1⁄4411, 56%). The most commonly treated lower limb spasticity presentation was equinovarus foot (n1⁄4429, 59%). Across all equinovarus foot treatment sessions (N1⁄41609), percentage injected and dose (mode) injected into each muscle are as follows: gastrocnemius (79%, 100U), soleus (70%, 100U), tibialis posterior (48%, 50U), flexor digitorum longus (21%, 50U), flexor hallucis longus (8%, 50U) and other muscle (13%, 50U). EMG was frequently used to localize the muscles to treat equinovarus foot (>40%). Across all treatments during the 2-year period, 95% of physicians and 85% of patients reported being satisfied/ extremely satisfied that treatment helped manage spasticity, 89% of physicians and 76% of patients reported treatment benefit was sustained, and 98% of physicians and 92% of patients would definitely/probably continue treatment with onabotulinumtoxinA. 261 patients (36%) reported 831 adverse events (AEs); 23 AEs in 20 patients (3%) were considered treatment-related. 94 patients (13%) reported 195 serious AEs; 3 serious AEs in 2 patients (0.3%) were considered treatment-related. No new safety signals were identified. Conclusions: The ASPIRE study provides valuable, real-world data on dosing, injection guidance, and muscle targeting over 2 years, that may help guide clinical strategies. ASPIRE captured the individualized nature of onabotulinumtoxinA utilization for spasticity, while demonstrating consistently high satisfaction. These results add to the body of evidence on the safety and effectiveness of onabotulinumtoxinA for spasticity. Level of Evidence: Level IV