Quantifying patterns of upper limb motor change following BTX-A injection in adult spasticity management

Barden, Hannah Louise Holman; Baguley, Ian; Nott, Melissa; Chapparo, Christine

doi:10.3109/02699052.2015.1071429

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…[10][11][12] Historically, composite outcome measures used in rehabilitation studies have tended to be generated from passive resistance measures, for example, by summing modified Ashworth Scale scores of multiple joints to assess muscle tone changes in the affected limb. [18][19][20][21][22][23][24][25][26][27][28][29][30] Although helpful, these approaches have overlooked assessment of active motion or active function. A "composite functional index" has been developed, which assesses perceived function involving mostly passive movements.…”

Section: Correlations Between CX a And Functional Outcomesmentioning

confidence: 99%

Composite active range of motion (CX_A) and relationship with active function in upper and lower limb spastic paresis

Bayle

Maisonobe

Raymond³

et al. 2020

Clin Rehabil

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Objective: The aim of this study is to evaluate a novel composite measure of active range of motion (XA) and determine whether this measure correlates with active function. Design: Post hoc analysis of two randomized, placebo-controlled, double-blind studies with open-label extensions exploring changes in active function with abobotulinumtoxinA. Setting: Tertiary rehabilitation centers in Australia, Europe, and the United States. Subjects: Adults with upper ( n = 254) or lower ( n = 345) limb spastic paresis following stroke or brain trauma. Interventions: AbobotulinumtoxinA (⩽5 treatment cycles) in the upper or lower limb. Main measures: XA was used to calculate a novel composite measure (CXA), defined as the sum of XA against elbow, wrist, and extrinsic finger flexors (upper limb) or soleus and gastrocnemius muscles (lower limb). Active function was assessed by the Modified Frenchay Scale and 10-m comfortable barefoot walking speed in the upper limb and lower limb, respectively. Correlations between CXA and active function at Weeks 4 and 12 of open-label cycles were explored. Results: CXA and active function were moderately correlated in the upper limb ( P < 0.0001–0.0004, r = 0.476–0.636) and weakly correlated in the lower limb ( P < 0.0001–0.0284, r = 0.186–0.285) at Weeks 4 and 12 of each open-label cycle. Changes in CXA and active function were weakly correlated only in the upper limb (Cycle 2 Week 12, P = 0.0160, r = 0.213; Cycle 3 Week 4, P = 0.0031, r = 0.296). Across cycles, CXA improvements peaked at Week 4, while functional improvements peaked at Week 12. Conclusion: CXA is a valid measure for functional impairments in spastic paresis. CXA improvements following abobotulinumtoxinA injection correlated with and preceded active functional improvements.

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Section: Correlations Between CX a And Functional Outcomesmentioning

confidence: 99%

Composite active range of motion (CX_A) and relationship with active function in upper and lower limb spastic paresis

Bayle

Maisonobe

Raymond³

et al. 2020

Clin Rehabil

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“…BTX affects the normal function of the neuromuscular conductor by preventing muscle contraction by reducing the production of acetylcholine from peripheral nerve cells. Chemical denervation occurs when substances are found on muscle fibers and induce muscular contraction (13). According to Pérez-Legaspi et al (14), SNAP-25 protein plays a crucial role in neuroexocytosis and transmitting a nerve impulse.…”

Section: Discussionmentioning

confidence: 99%

Expression of Ki67 in submandibular salivary glands of rabbits after BTX injection: Histological and immunohistochemical study

Ahmed

Mammdoh

2022

IJVS

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This study aimed to examine the possible histological effects of local injections of BTX in rabbits submandibular SGs and to find the dose-dependent and time relationship between injections and study immunohistochemistry expression of Ki67. Thirty male rabbits randomly divided into 3 groups (10 rabbits for Each) 1st group: control (without treatment), 2 nd group treated with 5U of BTX and 3 rd group treated with 10U of BTX, five animals of each group were sacrificed in 1st week of treatment and another five animals sacrificed in 4 th week of treatment. The rabbit was anesthetized then injected with the BTX in the gland. The histopathological changes in Group 5, 10 Unit BTX (1 st week) were vacuole degeneration of mucous acini cells, degeneration of serous acini cells, while the lesions showed hyperplasia and necrosis of epithelial cells lining striated ducts, necrosis of serous acini epithelium. The Diameter of mucous acini were found to be significantly increased in 10 Unit BTX groups. During the 1 st and 4 th weeks, the surface area of the striated ducts in the 5-and 10-unit BTX groups increased significantly, and the number of striated ducts in the 10 Unit BTX group decreased significantly when compared to the 1st week period of the same group. BTX groups revealed moderate to weak positive cytoplasmic reactivity for Ki67 protein in the parenchymal tissue of the glands. We conclude that BTX causes histological changes in the salivary gland as well as affecting Ki67. This data could be used in a future study to investigate the usage of BTX in cancer treatment.

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“…We compared the Comprehensive Spasticity Scale (CSS) score, 14 Gross Motor Function Measure (GMFM) score, 15 and walking speed before the treatment and 6 weeks and 3 months after the treatment. The classification of CSS score was based on Achilles tendon reflex (0-4), muscle tension of plantar flexor muscles increasing (0-8), and ankle claws (14), and less than 7 was defined as spasm, 7 to 9 as mild spasm, 10 to 12 as moderate spasm, and 13 to 16 as severe spasm.…”

Section: Methodsmentioning

confidence: 99%

Therapeutic Effect Evaluation of Neuromuscular Electrical Stimulation With or Without Strengthening Exercise on Spastic Cerebral Palsy

Niu

Gao

et al. 2017

Clin Pediatr (Phila)

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The aims of this study were to investigate the effect of neuromuscular electrical stimulation (NMES) combined with strengthening exercise on movement in children with spastic cerebral palsy (CP). One hundred children with spastic CP were randomly divided into a treatment group (NMES and strengthening exercise, n = 50) and a control group (only NMES, n = 50). We compared the Comprehensive Spasticity Scale (CSS) score, Gross Motor Function Measure (GMFM) score, and walking speed before treatment and 6 weeks and 3 months after treatment between the 2 groups. There was no difference in CSS score between the treatment and control groups before the therapy (12.0 ± 3.4 vs 12.3 ± 3.6), which decreased much more in the treatment group after 6 weeks (7.6 ± 3.0 vs 9.5 ± 2.8) and 3 months (7.4 ± 2.4 vs 9.4 ± 2.6) with significant differences ( P < .05). No difference in GMFM score was observed between the treatment and control groups before the therapy (44.5 ± 13.2 vs 44.0 ± 12.6), which increased much more in the treatment group after 6 weeks (70.6 ± 15.2 vs 56.7 ± 14.3) and 3 months (71.0 ± 16.4 vs 58.0 ± 15.6) with significant differences ( P < .05). The walking speed improved over time, which was the same before the treatment (0.43 ± 0.13 m/s vs 0.45 ± 0.14 m/s), and was significantly greater in the treatment group than that in the control group (6 weeks: 0.69 ± 0.15 m/s vs 0.56 ± 0.12 m/s, P < .05; 3 months: 0.72 ± 0.17 m/s vs 0.57 ± 0.18 m/s, P < .05). NMES combined with strengthening exercise was more effective than NMES alone in the recovery of spastic CP.

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Quantifying patterns of upper limb motor change following BTX-A injection in adult spasticity management

Cited by 5 publications

References 39 publications

Composite active range of motion (CX_A) and relationship with active function in upper and lower limb spastic paresis

Composite active range of motion (CX_A) and relationship with active function in upper and lower limb spastic paresis

Expression of Ki67 in submandibular salivary glands of rabbits after BTX injection: Histological and immunohistochemical study

Therapeutic Effect Evaluation of Neuromuscular Electrical Stimulation With or Without Strengthening Exercise on Spastic Cerebral Palsy

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Quantifying patterns of upper limb motor change following BTX-A injection in adult spasticity management

Cited by 5 publications

References 39 publications

Composite active range of motion (CXA) and relationship with active function in upper and lower limb spastic paresis

Composite active range of motion (CXA) and relationship with active function in upper and lower limb spastic paresis

Expression of Ki67 in submandibular salivary glands of rabbits after BTX injection: Histological and immunohistochemical study

Therapeutic Effect Evaluation of Neuromuscular Electrical Stimulation With or Without Strengthening Exercise on Spastic Cerebral Palsy

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Composite active range of motion (CX_A) and relationship with active function in upper and lower limb spastic paresis

Composite active range of motion (CX_A) and relationship with active function in upper and lower limb spastic paresis