{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T20:17:23Z","timestamp":1771273043792,"version":"3.50.1"},"reference-count":27,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,4,23]]},"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe real-life practice and person-centred outcomes in the treatment of poststroke upper limb spasticity with botulinum toxin A (BoNT-A).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Observational, prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>84 secondary care centres in 22 countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>456 adults (\u226518\u2005years) with poststroke upper limb spasticity treated with one cycle of BoNT-A.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods\/outcomes<\/jats:title><jats:p>Muscle selection, BoNT-A preparation, injection technique and timing of follow-up were conducted according to routine practice for each centre. Primary outcome: achievement of the patient's primary goal for treatment using goal-attainment scaling (GAS). Measurements of spasticity, standardised outcome measures and global benefits were also recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median number of injected muscles was 5 (range 1\u201315) and the most frequently injected muscles were the long finger flexors, followed by biceps and brachioradialis. The median (range) follow-up time was 14 (2.6 to 32.3) weeks. The common primary treatment goals were passive function (132 (28.9%)), active function (104 (22.8%)), pain (61 (13.4%)), impairment (105 (23%)), involuntary movement (41 (9%)) and mobility (10 (2.2%)). Overall, 363 (79.6%) (95% CI 75.6% to 83.2%) patients achieved (or overachieved) their primary goal and 355 (75.4%) (95% CI 71.2% to 79.2%) achieved their secondary goal. Mean (SD) change from baseline in GAS T-scores was 17.6 (11.0) (95% CI 16.4 to 18.8; p&lt;0.001). GAS T-scores were strongly correlated with global benefit and other standard measures (correlations of 0.38 and 0.63, respectively; p&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BoNT-A demonstrated a clinically significant effect on goal attainment for the real-life management of upper-limb spasticity following stroke. The study confirms the feasibility of a common international data set to collect systematic prospective data, and of using GAS to capture person-centred outcomes relating to passive and active functions and to pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Registration<\/jats:title><jats:p>ClinicalTrials.gov identifier:<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01020500\">NCT01020500<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2013-002771","type":"journal-article","created":{"date-parts":[[2013,6,22]],"date-time":"2013-06-22T00:17:42Z","timestamp":1371860262000},"page":"e002771","source":"Crossref","is-referenced-by-count":64,"title":["Results from the Upper Limb International Spasticity Study-II (ULIS-II): a large, international, prospective cohort study investigating practice and goal attainment following treatment with botulinum toxin A in real-life clinical management"],"prefix":"10.1136","volume":"3","clinical-trial-number":[{"clinical-trial-number":"nct01020500","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Lynne","family":"Turner-Stokes","sequence":"first","affiliation":[]},{"given":"Klemens","family":"Fheodoroff","sequence":"additional","affiliation":[]},{"given":"Jorge","family":"Jacinto","sequence":"additional","affiliation":[]},{"given":"Pascal","family":"Maisonobe","sequence":"additional","affiliation":[]}],"member":"239","published-online":{"date-parts":[[2013,6,6]]},"reference":[{"key":"2024051504381263000_3.6.e002771.1","unstructured":"Spasticity in adults: management using botulinum toxin. 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