Abstract
Challenges remain in measuring functional upper limb (UL) outcomes following Botulinum Toxin A (BTX-A) injections for muscle spasticity. Few measures exist to evaluate personally meaningful UL performance. The Upper Limb Performance Assessment (ULPA) is an observer-rated measure using patient-centred and selected tasks in real-world conditions. This multicentre, pre/post observational study examined the ULPA’s ability to measure motor function of adults with UL spasticity following acquired brain injury on self-selected goals. The ULPA detected change in UL functional use for self-selected goals, with improved Task Performance Mastery and reduced Excessive and Missing task-specific movements. This corresponded with an increased number of Expected movements for the task. ULPA sub-measures correlated with goal attainment as measured by Goal Attainment Scaling. The ULPA, a skilled clinical observation measure, can detect change in functional UL performance following BTX-A injection in adults with acquired brain injury.
Plain Language Summary
People often experience changes in arm and/or hand use after acquired brain injuries such as stroke from difficulties such as muscle weakness or impaired relaxation. Measuring changes in how a person uses their arm and hand during personally meaningful tasks is important for Occupational Therapists to evaluate the impact of therapies and monitor everyday arm and hand use over time. The Upper Limb Performance Assessment (ULPA) is a skilled observation measure using a systematic movement analysis to evaluate arm and hand movements affected by stroke and improved by therapy. This pre/post Botulinum Toxin A injection study demonstrated that the ULPA can detect change in arm and hand use in self-selected tasks in adults. Specifically, patients were able to master or complete more of their tasks and were able to use more of the arm and hand movements following injection.
Get full access to this article
View all access options for this article.