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

Toxins (Basel). 2023 Nov 29;15(12):676. doi: 10.3390/toxins15120676.

Abstract

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.

Keywords: GAS; GO-FAST; SMART treatment goals; goal-setting.

MeSH terms

  • Botulinum Toxins, Type A* / therapeutic use
  • Goals
  • Humans
  • Muscle Spasticity / drug therapy
  • Muscle Spasticity / rehabilitation
  • Muscles
  • Neuromuscular Agents* / therapeutic use
  • Stroke* / complications
  • Stroke* / drug therapy
  • Treatment Outcome
  • Upper Extremity

Substances

  • Botulinum Toxins, Type A
  • Neuromuscular Agents

Grants and funding

The Toxnet group is supported by Merz Therapeutics GmbH. The medical writing for this manuscript was funded by Merz Therapeutics GmbH and provided by Ali Hutton and Brenda McCleary. None of the authors were paid for contributing to this manuscript.