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Selecting Goals and Target Muscles for Botulinum Toxin A Injection Using the Goal Oriented Facilitated Approach to Spasticity Treatment (GO-FAST) Tool (2023)

The article introduces the new 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.

Supported by Merz Therapeutics GmbH

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Award scoring criteria

The following criteria will be judged out of a score of 5; (1 is suboptimal; 2 is adequate; 3 is good; 4 is very good; 5 is excellent)

GENERAL

  • Days per week working in spasticity management
  • Average number of spasticity patients managed per month
  • Environment and clinical team (type of institution, location, size/structure of clinical team, particular patient needs)
  • Role of responsibility in managing patients with spasticity
  • Scientific appointments in spasticity
  • Honours for work undertaken in spasticity

SCHOLARLY

  • Number of research projects investigating relevant aspects of spasticity management
  • Impact of research projects investigating relevant aspects of spasticity management
  • Number of peer-reviewed publications on topic
    Number of presentations of research at international meetings
  • Number of presentations at national conferences
  • Teaching/mentorship of younger injectors
  • h-index

CLINICAL

  • Evidence of development or growth of a spasticity program at the applicant’s practice or institution
  • Breadth of services provided, including medications, toxins, physical interventions, and Intrathecal Baclofen Therapy (ITB)
  • Role of responsibility in managing patients with spasticity

ENDORSEMENT

  • Endorsed by senior peer

In the event of a tie, based on the above scoring criteria, the Toxnet Co-Chairs will make the final decision.