International Journal of Physical Medicine & Rehabilitation
Open Access

Abstract

Treatment of Spasticity with Botulinum Toxin: The Stroke Patient’s Perspective

Amanda McIntyre, Shannon Janzen, Thomas Miller, Keith Sequeira, Michael Payne, Robert Teasell and Ricardo Viana

Objective: To explore self-reported reasons why individuals continue to receive botulinum toxin for treatment of their tone related impairment (spasticity).

Methods: Qualitative cross-sectional study, using semi-structured interviews, exploring patient reports of expectations, outcomes, experiences and perceptions of botulinum toxin injections. Interviews were digitally audio recorded and transcribed verbatim. Inductive content analysis was used to identify themes. Analysis began after the first interview was completed and continued in parallel with data collection until saturation of themes was reached.

Results: Content analysis of the interview transcripts identified the following thematic categories: 1) Themes with Functional Implication, including a) Impact on Mobility, b) Impact on Activities of Daily Living Performance, and c) Regional Pain Control, as well as 2) Themes with Psychosocial Implications, including a) Limb Appearance and b) the Physician-Patient Relationship. Participants had realistic treatment goals and expectations and the decision to continue receiving botulinum toxin was based on these goals, as well as, in part, influenced by strong positive relationships with their physicians.

Conclusions: This study provides insight into why patients choose to continue receiving treatment for their spasticity. These findings can help physicians to better set individual goals, expectations and treatment plans for patients and improve outcomes.