Quality of Life Assessment Using the Leg Activity Measure in Ambulatory Individuals With Leg Spasticity: Findings From a Longitudinal, Observational Study Evaluating the Effectiveness of AbobotulinumtoxinA in Routine Practice

IF 2 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation Pub Date : 2026-06-01 Epub Date: 2026-03-12 DOI:10.1016/j.arrct.2026.100611

Stephen Ashford PhD , Alberto Esquenazi MD , Richard D. Zorowitz MD , Mathieu Beneteau MSc , Pascal Maisonobe MSc , Christian Hannes PhD , Jorge Jacinto MD , AboLiSh Study group

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Abstract

Objective

To evaluate the effect of repeat abobotulinumtoxinA treatment on quality of life (QOL) in patients with leg spasticity.

Design

Secondary analysis of the prospective, longitudinal (16mo), observational AboLiSh study.

Setting

Specialist neurorehabilitation centers across 9 countries.

Participants

Ambulatory adults (66.4% men, mean age 53.9y) with unilateral lower limb spasticity able to take ≥5 steps with or without assistance.

Interventions

Patients were treated with abobotulinumtoxinA (up to 6 cycles) per local guidelines to achieve individualized treatment goals.

Main Outcome Measures

QOL was assessed at the start of each cycle using the symptom-specific Leg Activity measure (LegA; Parts A: passive function, B: active function, C: QOL impact) and the generic EQ-5D-5L scale.

Results

At the population level, QOL improved on both scales across the first 4 treatment cycles. LegA Part C scores decreased and EQ-5D-5L index values increased with repeat treatment. LegA Part C scores showed moderate-to-strong inverse correlations with EQ-5D-5L index values at each cycle (Pearson’s R: Cycle 1: −0.66; Cycle 2: −0.57; Cycle 3: −0.60; Cycle 4: −0.59; all P<.0001). LegA Part A scores were moderately-to-strongly correlated with EQ-5D-5L self-care domain scores across cycles 1-3 (Pearson’s R: Cycle 1: 0.60; Cycle 2: 0.58; Cycle 3: 0.50; Cycle 4: 0.34; all P<.0001). LegA Part B scores were moderately-to-strongly correlated with EQ-5D-5L mobility domain scores across all cycles (Pearson’s R: Cycle 1, 0.58; Cycle 2, 0.57; Cycle 3, 0.57; Cycle 4, 0.59; all P<.0001).

Conclusions

Repeat lower limb treatment with abobotulinumtoxinA improved QOL as assessed by both symptom-specific and generic instruments. The significant correlations between LegA Part C and EQ-5D-5L support validity of the LegA to assess the impact of treatment on QOL in patients with leg spasticity.

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使用腿部活动测量对下肢痉挛患者的生活质量进行评估：一项纵向观察性研究的结果，评估肉毒杆菌毒素在常规实践中的有效性

目的评价肉毒杆菌毒素重复治疗对腿部痉挛患者生活质量的影响。设计对前瞻性、纵向（16个月）观察性研究进行二次分析。在9个国家设立专业的神经康复中心。参与者：单侧下肢痉挛的可调节成年人（66.4%男性，平均年龄53.9岁），在有或没有帮助的情况下能够行走≥5步。干预：根据当地指南，患者接受肉毒杆菌毒素治疗（最多6个周期），以实现个体化治疗目标。在每个周期开始时，使用症状特异性腿部活动测量（LegA； A部分：被动功能，B部分：主动功能，C部分：生活质量影响）和通用EQ-5D-5L量表评估生活质量。结果在人群水平上，在前4个治疗周期中，两个量表的生活质量均有所改善。重复治疗后，LegA Part C评分降低，EQ-5D-5L指数升高。LegA Part C评分在每个周期中与EQ-5D-5L指数值呈中等至强的负相关（Pearson’s R: cycle 1:−0.66;cycle 2:−0.57;cycle 3:−0.60;cycle 4:−0.59；所有P<； 0.0001）。LegA Part A评分与EQ-5D-5L自我护理领域评分在周期1-3中呈中至强相关（Pearson’s R：周期1:0.60；周期2:0.58；周期3:0.50；周期4:0.34；所有P<均为0.0001）。在所有周期中，LegA B部分分数与EQ-5D-5L迁移域分数呈中等至强相关（Pearson’s R：周期1,0.58；周期2,0.57；周期3,0.57；周期4,0.59；所有P<； 0.0001）。结论通过症状特异性和通用指标评估，肉毒杆菌毒素重复下肢治疗可改善患者的生活质量。LegA C部分与EQ-5D-5L之间的显著相关性支持LegA评估治疗对腿部痉挛患者生活质量影响的有效性。

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