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General Rehabilitation

Leg Activity Measure (LegA) Sensitivity to Change Following Treatment of Lower Limb Spasticity With a Single Cycle of AbobotulinumtoxinA in an Ambulant Population

(Research Hub Theater) Leg Activity Measure (LegA) Sensitivity to Change Following Treatment of Lower Limb Spasticity with a Single Cycle of AbobotulinumtoxinA in an Ambulant Population

Thursday, November 16, 2023
5:00 PM – 7:00 PM CT

    Co-Author(s)

  • Stephen Andrew Ashford, PhD

    Consultant Physiotherapist and Reader in Rehabilitation
    North West London Hospitals Nhs TrustKing's Coll London
    London, England, United Kingdom

  • Jorge Jacinto, MD

    director de serviço da empresa CMRA
    Centro de Medicina de Reabilitaçãode Alcoitão, Serviço de Reabilitação de adultos 3, Estoril, Portugal
    Estoril, Lisboa, Portugal

  • RICHARD D. ZOROWITZ, MD

    Chief Medical Informatics Officer and Professor of Clinical Rehabilitation Medicine
    MedStar National Rehabilitation Network and Georgetown University School of Medicine, Washington, DC, USA
    Georgetown University School of Medicine
    WASHINGTON, District of Columbia

  • PM

    Pascal Maisonobe, Other

    Biostatistics & data management director
    Ipsen, Boulogne-Billancourt, France
    Boulogne-Billancourt, France, Ile-de-France, France

  • CH

    Christian Hannes, PhD

    Global Medical Affairs, Senior Manager
    Ipsen, Boulogne-Billancourt, France
    Boulogne-Billancourt, Ile-de-France, France

    • Primary Author(s)

  • Alberto Esquenazi, MD

    Chairman and Professor, Department of PM&R and Director of Gait and Motion Analysis Laboratory
    MossRehab & Albert Einstein Medical Center, Elkins Park, PA, USA.
    Elkins Park, Pennsylvania

Background and/or Objectives: The Leg Activity Measure (LegA) was developed as a patient/carer rated outcome measure of active and passive function in the paretic lower limb, particularly when associated with spasticity. Here, we evaluate the LegA sensitivity to change following treatment of lower limb spasticity (LLS) with a single cycle of abobotulinumtoxinA (aboBoNT-A) and rehabilitation in an ambulatory population.

Design: AboLiSh (NCT04050527) is a prospective, longitudinal, observational study.

Setting: International, multicenter.

Participants: Adults aged ≥18 years with unilateral LLS, who are able to take ≥5 steps with or without assistance.

Interventions: AboBoNT-A injections, for which, prescription decisions were made prior to, and independently of study enrollment.

Main Outcome Measures: LLS related treatment goals set by the participants at baseline. Where possible, goal outcome is supported by standardized measurement using the LegA.

Results: Of the 376 patients included in the interim Treatment Cycle 1 analysis, 278 had ≥1 assessment using the LegA. Part A assesses the patient’s ability to care for the affected leg (passive function); mean±SD scores reduced (improved) from 8.8±7.2 at baseline to 7.6±6.2 at end of cycle (mean [95%CI] change of -1.4 [-1.8, -0.9], n=261). Part B assesses the patient’s ability to independently complete activities using the affected leg (active function); mean±SD scores improved from 24.4±13.1 to 22.2±11.8 (mean [95%CI] change of -2.6 [-3.4, -1.9], n=261). Part C assesses the impact of spasticity on quality of life (QoL); mean±SD scores improved from 15.8±7.2 to 13.7±6.5 (mean [95%CI] change of -2.3 [-2.8, -1.7], n=258).

Conclusions: Findings from this observational study of aboBoNT-A in the routine management of LLS confirm the sensitivity of the LegA for spasticity intervention and further support its use in the ambulatory population. For this cohort, improvements in active function and QoL were ≥2 absolute points, indicating clinically relevant improvement.