Botulinum toxin A (BTA) injections are an effective method of spasticity treatment in cerebral palsy (CP) but still there are a lot of questions about the selection of target muscles. The article summarizes currently accepted approaches to the goal setting and prioritizing in CP botulinum toxin therapy according to the form of CP, GMFCS level, age, spasticity level and other factors.
The authors discuss the Goal Attainment Scale (GAS) and its possibilities in the BTA injections planning and evaluation of the results. Attention is also paid to the 'key muscle concept' in the multilevel spasticity treatment in CP and the additional factors that can influence the effectiveness of injections.
The above approaches to the detection of patients' problems and setting of BTA treatment goals can help to prevent serious mistakes and disappointment in this effective method of treatment.