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Equinovarus foot was treated most often (80.9% of patients), followed by flexed knee (26.0%), stiff extended knee (22.5%), and flexed toes (22.3%). OnabotulinumtoxinA doses ranged between 10 and 1100\u2009U across all presentations. Electromyography (EMG) was most commonly used for injection localization (\u226541.1% of treatment sessions). Despite low patient response on the satisfaction questionnaire, clinicians (94.6% of treatment sessions) and patients (84.5%) reported satisfaction\/extreme satisfaction that treatment helped manage spasticity, and clinicians (98.3%) and patients (91.6%) would probably\/definitely continue onabotulinumtoxinA treatment. These data should be interpreted with care. Twenty\u2010one adverse events (AEs) in 18 patients (3.4%) were considered treatment\u2010related. Sixty\u2010seven patients (12.6%) reported 138 serious AEs; 3 serious AEs in two patients (0.4%) were considered treatment\u2010related. No new safety signals were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ASPIRE provides long\u2010term observational data on the treatment of lower limb spasticity with onabotulinumtoxinA. Real\u2010world data from this primary analysis can help to guide the clinical use of onabotulinumtoxinA to improve spasticity management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12517","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T14:20:11Z","timestamp":1604586011000},"page":"1079-1093","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>Long\u2010Term<\/scp> Observational Results from the <scp>ASPIRE<\/scp> Study: <scp>OnabotulinumtoxinA<\/scp> Treatment for Adult Lower Limb Spasticity"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0698-6424","authenticated-orcid":false,"given":"Alberto","family":"Esquenazi","sequence":"first","affiliation":[{"name":"MossRehab Gait and Motion Analysis Laboratory  Elkins Park PA 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