Botulinum toxin type A in post-stroke upper limb spasticity

Kaji, Ryuji; Osako, Yuka; Suyama, Kazuaki; Maeda, Toshio; Uechi, Yasuyuki; Iwasaki, Masanori

doi:10.1185/03007995.2010.497103

Cited by 100 publications

(113 citation statements)

References 23 publications

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“…Spasticity of lower extremities was improved but there was no difference in walking compared with placebo (18,19). In a multi-center, double-blind, randomized, prospective study, the efficacy of BTX-A injection into both lower and upper extremities in patients with stroke was evaluated (20). In this study resulted that BTX-A regards clinical and costeffectiveness of Botulinum toxin + standard care vs standard care alone in patients with upper and lower limb post-stroke spasticity typically seen in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Spasticity of upper extremity was evaluated with MAS and as a result, after 6 weeks, higher dose BTX-A resulted in lower MAS scores. Spasticity of lower extremities was improved but there was no difference in walking compared with placebo (18,19). In a multi-center, double-blind, randomized, prospective study, the efficacy of BTX-A injection into both lower and upper extremities in patients with stroke was evaluated (20).…”

Section: Discussionmentioning

confidence: 99%

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The Evaluation of Botulinum Toxin Injection Effect for Poststroke Spasticity Treatment

Demiryürek¹,

Gündoğdu²

2017

tnd

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Amaç: Bu çalışmada, inme sonrası üst ya da alt ekstremite spastisitesi gelişen hastaların tedavisinde Botulinum toksin-tip A (BTX-A) enjeksiyonunun spastisite ve spastisiteye bağlı ağrı tedavisindeki etkinliği ile günlük yaşam aktivitelerine olan etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem:Bu çalışmaya inme sonrası üst ekstremite ya da alt ekstremitede spastisite nedenli 249±41 U BTX-A uygulanmış 35 (23 sağ taraf, 12 sol taraf) hasta alındı. Üst ekstremitede dirsek, el bileği ve parmaklarda, alt ekstremitede ise bacak, diz ve ayak bileğinde spastisite derecesi; BTX-A enjeksiyonu öncesi, işlem sonrası 1. ay ve işlem sonrası 3. ay Modifiye Ashworth Skalası (MAS) ile değerlendirildi. Ayrıca BTX-A işlemi öncesi, işlem sonrası 1. ay ve işlem sonrası 3. ay günlük yaşam aktiviteleri Barthel indeksi ile, spastisiteye bağlı ağrı ise Vizüel Analog Skalası (VAS) ile değerlendirildi. Bulgular: Çalışmaya alınan hastaların yaş ortalaması 60±6 idi. Hastaların %69'unda üst ve alt ekstremite, %31'inde ise üst ya da alt ekstremite etkilenmişti. MAS, VAS ve Barthel indeksi kullanılarak BTX-A'nın tedavi öncesine göre anlamlı olarak spastisite ve ağrı şiddetinde azalma, fonksiyonellikte ve yaşam kalitesinde ise artma sağladığı sonucuna varıldı. Birinci ayda sağlanan faydanın 3. ay takiplerinde de sürdüğü saptandı.Sonuç: İnmeye bağlı spastisite tedavisinde BTX-A uygulanması yan etki açısından güvenli, hastaların ağrısını azaltan, fonksiyonelliği ve yaşam kalitesini artıran, uzun süreli etkinlik sağlayabilen bir yöntemdir.Anahtar Kelimeler: İnme, spastisite, botulinum toksin, ağrıObjective: In this study we aimed to evaluate the effectivity of treatment with the botulinum toxin-type A (BTX-A) on spasticity, spasticity-related pain, and the daily living activities in post-stroke patients with upper or lower limb spasticity. Materials and Methods:A total of 35 (23 right side, 12 left side) post-stroke patients who had upper and/or lower limb spasticity were enrolled to the study. BTX-A (249±41 U) was applied to their affected extremities. The degree of spasticity in the upper (elbow, wrists, and fingers) and lower (leg, knee and ankle) extremities was evaluated before treatment, 1 month, and 3 months after treatment using Modified Ashworth Scale (MAS). Daily life activities and severity of spasticity-related pain were also evaluated using the Barthel index and Visual Analogue Scale (VAS) at the same time points. Results:The average age of the patients in the study was 60±6 years. Both upper and lower extremities were affected in 69%, whereas upper or lower extremities were affected in 31% of patients. BTX-A provided improvement in severity of the spasticity, pain scale, functionality, and quality of life according to the MAS, VAS, and Barthel indexes.The benefits were sustained in the first 3 months of the post-treatment.Conclusion: BTX-A in the treatment of post-stroke spasticity is a reliable method in terms of adverse effects, pain reduction, its ability to provide long-term effectiveness, and increase functionality an...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Evaluation of Botulinum Toxin Injection Effect for Poststroke Spasticity Treatment

Demiryürek¹,

Gündoğdu²

2017

tnd

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“…Ско-рость ходьбы и характер походки не продемонстри-ровали значимых различий, однако наблюдалась тенденция к улучшению в группе БТА. Частота воз-никновения связанных с лечением побочных эффек-тов в группах БТА и плацебо существенно не различа-лась [48].…”

Section: том 7 Volunclassified

“…Flexor hallucis longus 50 (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50) Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.…”

Section: Flexed Toesunclassified

Botulinum toxin treatment of lower extremity spasticity

Khatkova¹,

Akulov²,

Orlova³

et al. 2017

Neuromuscular Diseases

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“…The benefit from BoNT-A is maintained after repeated treatment cycles(66-67) and thus, BoNT-A has been thought to be a first line treatment in focal/multifocal spasticity (68). In addition, BoNT treatment has been shown to improve associated reactions in ULS(69) reduce predetermined disability parameters (including pain) (70)(71)(72)(73), reduce carer burden (70,(73)(74), improve person-centered goals(75) and self-reported efficacy with safety (76). However, efficacy of BoNT-A for improvement of motor control and active functions have not been attained (77).…”

Section: Evidence-based Medicinementioning

confidence: 99%

Dystonia, Spasticity and Botulinum Toxin Therapy: Rationale, Evidences and Clinical Context

Rosales¹

2012

Dystonia - The Many Facets

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Botulinum toxin type A in post-stroke upper limb spasticity

Abstract: Higher-dose BoNTA reduced spasticity in upper limb muscles and improved ADL performance in terms of limb position and dressing. BoNTA is safe and effective in the treatment of post-stroke upper limb spasticity.

Cited by 100 publications

References 23 publications

The Evaluation of Botulinum Toxin Injection Effect for Poststroke Spasticity Treatment

The Evaluation of Botulinum Toxin Injection Effect for Poststroke Spasticity Treatment

Botulinum toxin treatment of lower extremity spasticity

Dystonia, Spasticity and Botulinum Toxin Therapy: Rationale, Evidences and Clinical Context

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