Arm Activity measure (ArmA) application for recording functional gain following focal spasticity treatment

Background and Aims: The Arm Activity measure (ArmA) is a new measure for recording the pattern of change in passive function after focal spasticity intervention. This study aimed to demonstrate the application of the ArmA for measuring passive and active functional movement. Methods An open-label prospective cohort study was conducted within a two-centre specialist spasticity management program. Outcome measures used were the ArmA, the Modified Ashworth Scale (MAS) and the Leeds Adult Spasticity Impact Scale (LASIS). Measurement was undertaken at baseline, at 8 weeks and at 16 weeks. Participants (n=58) presenting for treatment of upper limb spasticity were included and comprised of 32 men and 26 women, with a mean age of 47 years (SD=17.5). Participants received a single administration of BoNT (Dysport®, Ipsen, Slough, UK; or BOTOX®, Allergan, Irvine, CA, USA) following baseline assessment as part of routine clinical practice. Results Significant changes were demonstrated over the 16-week period in both the MAS (Xr 2 =66.6; P<0.005) and the ArmA passive function subscale (Xr 2 =11.9; P<0.005) (e.g. improved ease of dressing and hygiene). No change was identified in the ArmA active function subscale. Comparison of change at individual time-points showed the gain in passive function to be maintained at 16 weeks (Z=-2.6; P<0.01). Conclusion Significant gains in passive function were recorded by ArmA at 8 weeks, and maintained at 16 weeks post-injection in the context of on-going physical intervention.