The selection of proper therapy during the administration of botulinum toxin in spastic patients is a great challenge for therapists. When developing a rehabilitation program, we should maximize the positive effect of the temporary relaxation of the injected muscles, while ensuring that the level of learned functions is kept as high as possible. To monitor the progress of therapy, it is necessary to use inter-operative tests giving the possibility to verify the effectiveness of the selected treatment model. The analysis of subjective and objective tests, in this case, does not give an unequivocal answer about the effectiveness of treatment. Perhaps it would be necessary in such a case to develop an algorithm of selected structural and functional tests that would give a fuller knowledge about the current condition of the patient being treated. The discrepancy in the results also shows the problem between the patient's real needs resulting from the improvement of comfort of life and the goals set by the clinicians. In many clinical trials, botulinum toxin has a time criterion to rule out spontaneous improvement (e.g. 6 months after stroke). However, it is most effective when treatment is started relatively early. In the analyzed case, the period is over 10ten years. Our goal was not to eliminate spasticity, which prevented: muscle atrophy, venous thromboembolism and the development of secondary local osteoporosis, but only its partial reduction enabling proper functioning of the patient.