Success in Pain Management Associated with Spasticity in Stroke Measured by Goal Attainment Scaling
DOI:
https://doi.org/10.25759/spmfr.261Keywords:
Botulinum Toxins, Type A, Muscle Spasticity, Pain Management, Pain Measurement, Stroke/complicationsAbstract
Introduction: The pain associated with spasticity after stroke is common and interfere with the functionality and quality of life, and their treatment is not easy in some cases. Currently botulinum toxin type A (BoNTA) has an alternative to established treatments, so the authors aims to evaluate the success of their treatment in pain in patients with stroke sequelae, measured by goal attainment scaling.
Material and Methods: Prospective, non-interventional study. Cohort of 82 cases treated between 01/03/09 and 31/10/12. Included patients aged 18 to 85 years with a diagnosis of stroke, in which pain was a target for treatment. The scales used were the numerical pain scale and Likert scale. The measuring success was made with goal attainment scaling. The treatment met the characteristics and expectations of each case. The results were analyzed with parametric tests and non-parametric tests.
Results and Discussion: Sample of 37 men and 39 women with a mean age of 59 years. The pain affected more the upper limb (77.6%), and was most frequent in shoulder (49%). The numerical pain scale was used in 53 cases and the mean value before and after treatment was 7/10 and 3/10 respectively. In 49 (92%) patients, the decreased amount of one or more degrees in numerical pain scale. The difference was significant (p < 0.001). The Likert scale was used in 23 cases. After treatment 20 (87%) were “better” or “much better”. This result was significant (p < 0.001). The end goal attainment scaling score was 52 and its variation was 12 on average. In 61 (80%) cases this was clinically significant (≥ 10). The difference between initial and final scores was statistically significant (p < 0.001).
Conclusion: The goal attainment scaling was a valid instrument, which resulted in the successful delivery of objectives centered on the patient and their quality of life, and had good correlation with the results of standardized scales, used to measure the clinical results in the treatment of pain.
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