Selecting Goals and Target Muscles for Botulinum Toxin A Injection Using the Goal Oriented Facilitated Approach to Spasticity Treatment (GO-FAST) Tool
Jorge Jacinto,
Alexander Balbert,
Djamel Bensmail,
Stefano Carda,
Nathalie Draulans,
Thierry Deltombe,
Nicholas Ketchum,
Franco Molteni,
Rajiv Reebye
Affiliations
Jorge Jacinto
Alcoitão Medical Rehabilitation Centre, Rua Conde Barão, 2649-506 Alcabideche, Portugal
Alexander Balbert
Department of Adaptive Physical Training, Ural University of Physical Education, Sverdlovsk Regional Hospital for War Veterans, 620014 Yekaterinburg, Russia
Djamel Bensmail
Department of Physical and Rehabilitation Medicine, Raymond-Poincaré Teaching Hospital, APHP, Université Paris-Saclay, 92380 Garches, France
Stefano Carda
Department of Clinical Neurosciences, Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland
Nathalie Draulans
Department of Rehabilitation, Libra Rehabilitation and Audiology, 5022 KE Tilburg, The Netherlands
Thierry Deltombe
Department of Physical Medicine and Rehabilitation, Université Catholique de Louvain, Centre Hospitalier Universitaire de Namur, Godinne Site, Avenue Docteur G Therasse, 5530 Yvoir, Belgium
Nicholas Ketchum
Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, 9200 W., Milwaukee, WI 53226, USA
Franco Molteni
Villa Beretta Rehabilitation Center, Valduce Hospital, 23845 Costa Masnaga, Italy
Rajiv Reebye
Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
The objective of this article is to introduce the GO-FAST Tool (developed by the Toxnet group) to clinicians working in the field of neurological rehabilitation, specifically post-stroke spasticity management. The concepts utilized in the Tool and described in this article can be broadly grouped into five topics: the principles of patient-centred goal-setting; an algorithm for setting SMART (specific, measurable, attainable, realistic, and timed) treatment goals; goal-related target muscles and botulinum toxin type A dose determinants; goal attainment follow-up, scoring, and interpretation; and the multimodal approach to spasticity management. The Tool can enhance clinical practice by providing guided assistance with goal-setting and target muscle selection for botulinum toxin type A treatment. It also provides support with the follow-up evaluation of goal attainment and calculation of treatment success. The Tool is designed to be used by clinicians with varying levels of expertise in the field of neurological rehabilitation and post-stroke spasticity management, from those who are new to the field to those with many years of experience. A case study is presented in the Results Section of the article to illustrate the utility of the Tool in setting SMART treatment goals in the management of patients with post-stroke spasticity.
