Disability Changes After Treatment of Upper Limb Spasticity with Botulinum Toxin

Reiter, Frank; Danni, Maura; Ceravolo, M.G.; Provinciali, Leandro

doi:10.1177/154596839601000107

Cited by 21 publications

(15 citation statements)

References 12 publications

(8 reference statements)

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“…This finding substantiated a recent similar report (9) . Above results also showed significant improvement in Motricity index as compared to more generalised Functional Independence Measure (10,11) . Focal improvement of function were significantly detected by Motricity Index .Which tested key functional aspect of a particular joint muscle group.…”

Section: Modified Ashworth Scalementioning

confidence: 57%

Effect of Botulinum Toxin –A on Upper and Lower Limb Spasticity Assessed by FIM and Motricity Index

Iswarari¹

2018

jmscr

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Section: Modified Ashworth Scalementioning

confidence: 57%

Effect of Botulinum Toxin –A on Upper and Lower Limb Spasticity Assessed by FIM and Motricity Index

Iswarari¹

2018

jmscr

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“…The ef cacy of BTX-A treatment on tone and PROM was demonstrated by the RCT performed by Simpson et al (57) and supported by other studies (58,59,(61)(62)(63)(64)(65)(66). In addition, Hesse et al (60) found evidence of a synergistic effect of ES combined with BTX-A treatment.…”

Section: Botulinum Toxinmentioning

confidence: 68%

“…After the preliminary assessment, 12 studies were included for detailed methodological evaluation (57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68). Ten studies focused on the treatment of upper limb spasticity with BTX-A (57-66), one focused on alcohol neurolysis (67) and one study dealt with phenol neuromuscular blockade (68).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of upper extremity spasticity in stroke patients by focal neuronal or neuromuscular blockade: a systematic review of the literature

Kuijk¹,

Geurts²,

Bevaart³

et al. 2002

Journal of Rehabilitation Medicine

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Studies published from January 1966 until October 2000 on the clinical effects of focal neuronal and neuromuscular blockade in post stroke upper limb spasticity were identified. Twelve studies were included and evaluated on 13 methodological criteria. Ten studies on Botulinum toxin type A (BTX-A) treatment were found (of which 4 were randomised controlled trials (RCTs) and 6 were uncontrolled observational studies) as well as one uncontrolled observational study on phenol blockade of the subscapular muscle and one on alcohol blockade of the musculocutaneus nerve. The homogeneity of the patient groups with regard to diagnosis and their comparability with regard to functional prognosis and other sources of bias were generally unsatisfactory. Only two RCTs met predetermined criteria of minimal validity. There is evidence of effectiveness of BTX-A treatment on reducing muscle tone (varying between 0.8 and 2.0 points on the modified Ashworth scale) and improving passive range of motion at all arm-hand levels in chronic stroke patients for approximately 3-4 months. There is also preliminary evidence of a synergistic effect of concomitant electrostimulation. Taking into account a critical maximum dose of 100 MU Botox" (300-500 MU Dysport) for preserving active finger flexion, BTX-A treatment seems to be a safe focal spasmolytic treatment. Effectiveness of BTX-A treatment on improving functional abilities could not be convincingly demonstrated, although two subgroups may be identified that might specifically benefit at a functional level: (1) patients with mild spasticity and a potential for voluntary extensor activity and (2) patients with severe spasticity suffering from problems with positioning and taking care of the affected arm and hand. Larger controlled studies are needed to compare the effectiveness of BTX-A with other focal spasmolytic techniques paying special attention to individual goal assessment, the (duration of) functional benefits, co-treatment and aftercare, side-effects and cost-effectiveness.

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“…[30][31][32][33] [35][36][37][38][39][40][41][42][43][44] As an extension to a 12-week double-blind study, 41 111 patients were enrolled in a 42-week open label study. 45 In this study, repeated BTX injections for upper limb spasticity have resulted in significant and sustained improvement in both Disability Assessment and Ashworth Scores.…”

Section: Btx For Upper Limb Spasticitymentioning

confidence: 99%

Botulinum Toxin in Poststroke Spasticity

Özçakır

Sivrioğlu²

2007

Clinical Medicine & Research

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Poststroke hemiparesis, together with abnormal muscle tone, is a major cause of morbidity and disability. Although most hemiparetic patients are able to reach different ambulatory levels with rehabilitation efforts, upper and lower limb spasticity can impede activities of daily living, personal hygiene, ambulation and, in some cases, functional improvement.The goals of spasticity management include increasing mobility and range of motion, attaining better hygiene, improving splint wear and other functional activities. Conservative measures, such as positioning, stretching and exercise are essential in spasticity management, but alone often are inadequate to effectively control it. Oral antispastic medications often provide limited effects with short duration and frequent unwanted systemic side effects, such as weakness, sedation and dry mouth.Therefore, neuromuscular blockade by local injections have become the first choice for the treatment of focal spasticity, particularly in stroke patients. Botulinum toxin (BTX), being one of the most potent biological toxins, acts by blocking neuromuscular transmission via inhibiting acetylcholine release. Currently, focal spasticity is being treated successfully with BTX via injecting in the spastic muscles.Two antigenically distinct serotypes of BTX are available on the market as type A and B. Clinical studies of BTX used for spastic hemiplegic patients are reviewed in this article in two major categories, upper and lower limb applications. This review addresses efficacy in terms of outcome measures, such as muscle tone reduction and functional outcome, as well as safety issues. Application modifications of dose, dilutions, site of injections and combination therapies with BTX injections are also discussed.

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Disability Changes After Treatment of Upper Limb Spasticity with Botulinum Toxin

Cited by 21 publications

References 12 publications

Effect of Botulinum Toxin –A on Upper and Lower Limb Spasticity Assessed by FIM and Motricity Index

Effect of Botulinum Toxin –A on Upper and Lower Limb Spasticity Assessed by FIM and Motricity Index

Treatment of upper extremity spasticity in stroke patients by focal neuronal or neuromuscular blockade: a systematic review of the literature

Botulinum Toxin in Poststroke Spasticity

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