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Adverse events were monitored throughout the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 744 participants enrolled, 730 received \u22651 dose of onabotA; 275 participants received treatment with onabotA in both upper and lower limbs during \u22651 session; 39.3% of participants were na\u00efve to onabotA for spasticity. The mean (SD) total dose per treatment session ranged from 421.2 (195.3) to 499.6 (188.6) U. The most common baseline upper limb presentation was clenched fist (<jats:italic>n<\/jats:italic>\u2009=\u2009194, 70.5%); lower limb was equinovarus foot (<jats:italic>n<\/jats:italic>\u2009=\u2009219, 66.9%). High physician and participant satisfaction and improvements in pain, disability and QoL were reported after most treatments. Nine participants (3.3%) reported nine treatment\u2010related adverse events; two participants (0.7%) reported three serious treatment\u2010related severe adverse events. No new safety signals were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>More than a third of enrolled participants received at least one concurrent onabotA treatment of the upper and lower limbs, with reduced pain, disability, and improved QoL after treatment, consistent with the established safety profile of onabotA for the treatment of spasticity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.13195","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T11:59:28Z","timestamp":1717070368000},"page":"1176-1190","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pain, disability, and quality of life in participants after concurrent <scp>onabotulinumtoxinA<\/scp> treatment of upper and lower limb spasticity: Observational results from the <scp>ASPIRE<\/scp> study"],"prefix":"10.1002","volume":"16","author":[{"given":"Ganesh","family":"Bavikatte","sequence":"first","affiliation":[{"name":"The Walton Centre  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5681-1916","authenticated-orcid":false,"given":"Gerard E.","family":"Francisco","sequence":"additional","affiliation":[{"name":"UT Health Science Center McGovern Medical School and TIRR Memorial Hermann  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang H.","family":"Jost","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Freiburg  Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Baricich","sequence":"additional","affiliation":[{"name":"Universit\u00e0 del Piemonte Orientale  Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Duarte","sequence":"additional","affiliation":[{"name":"Hospital del Mar  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon F. 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