There were significant between group differences favoring the BoNT-A-treated group on COPM performance at 4 weeks ( estimated mean difference 2.2 , 95 % CI 0.8 , 3.5 ; P = .002 ) and for COPM satisfaction ( estimated mean difference 2.2 , 95 % CI 0.5 , 3.9 ; P = .01 ) .