The effects of botulinum toxin type A combined with extracorporeal shock wave therapy on triceps spasticity in stroke patients

Duan, Haoyang; Li, Z.; Liu, F.

doi:10.1016/j.rehab.2018.05.848

Cited by 3 publications

(2 citation statements)

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“…There is as yet no evidence that extracorporeal shockwave therapy reduces alpha motor neuron excitability, a neural component of spasticity. Several authors 16,[38][39][40] support the hypothesis that the combined effects of botulinum toxin plus extracorporeal shockwave affect the Figure 2. Overview of all studies to reduce spasticity before and after intervention.…”

Section: Discussionmentioning

confidence: 94%

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

et al. 2020

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Objective: To assess the effectiveness of Extracorporeal Shock Wave Therapy for reducing spasticity and improving functionality of the upper limb in stroke survivors. Data sources: A systematic review of MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, PEDro, REHABDATA, Scielo, Scopus, Web of Science, Tripdatabase and Epistemonikos from 1980 to April 2020 was carried out. Review methods: The bibliography was screened to identify randomized controlled clinical trials that applied extracorporeal shock waves to upper limb spastic muscles in post-stroke individuals. Two reviewers independently screened references, selected relevant studies, extracted data and assessed risk of bias using the PEDro scale. The primary outcome was spasticity and functionality of the upper limb. Results: A total of 1,103 studies were identified and 16 randomized controlled trials were finally included (764 individuals) were analyzed. A meta-analysis was performed and a beneficial effect on spasticity was found. The mean difference (MD) on the Modified Ashworth Scale for comparison extracorporeal shock wave versus sham was −0.28; with a 95% confidence interval (CI) from −0.54 to −0.03. The MD of the comparison of extracorporeal shock wave plus conventional physiotherapy versus conventional physiotherapy was −1.78; 95% CI from −2.02 to −1.53. The MD for upper limb motor-function using the Fugl Meyer Assessment was 0.94; 95% CI from 0.42 to 1.47 in the short term and 0.97; 95% CI from 0.19 to 1.74 in the medium term. Conclusion: The extracorporeal shock wave therapy is effective for reducing upper limb spasticity. Adding it to conventional therapy provides an additional benefit.

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Section: Discussionmentioning

confidence: 94%

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

et al. 2020

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“…Further evidence published by Mihai et al underscored the benefits of this combination, indicating significant improvements in spasticity management across various patient groups [ 160 ]. Duan et al specifically noted that the use of BoNT-A with ESWT significantly relieved triceps spasticity, improved motor function, and daily living ability in stroke patients [ 161 ]. This finding is particularly compelling as it demonstrates the real-world impact of this combined approach on patient functionality and quality of life.…”

Section: Discussionmentioning

confidence: 99%

The Role of Botulinum Toxin Type-A in Spasticity: Research Trends from a Bibliometric Analysis

Facciorusso,

Spina,

Picelli

et al. 2024

Toxins

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Botulinum toxin type-A (BoNT-A) has emerged as a key therapeutic agent for the management of spasticity. This paper presents a comprehensive bibliometric and visual analysis of research concerning BoNT-A treatment of spasticity to elucidate current trends and future directions in this research area. A search was conducted in the Web of Science database for articles focused on the use of BoNT-A in spasticity published between 2000 and 2022. We extracted various metrics, including counts of publications and contributions from different countries, institutions, authors, and journals. Analytical methods in CiteSpace were employed for the examination of co-citations, collaborations, and the co-occurrence of keywords. Our search yielded 1489 publications. Analysis revealed a consistent annual increase in research output. The United States, United Kingdom, and Italy were the leading contributors. The top institution in this research was Assistance Publique Hopitaux, Paris. The journal containing the highest number of relevant publications was Toxins. Key frequently occurring keywords were ‘stroke’, ‘cerebral palsy’, ‘adult spasticity’, and ‘upper extremity’. This study identified 12 clusters of keywords and 15 clusters of co-cited references, indicating the main focus areas and emerging themes in this field. This study comprehensively analyzed and summarized trends in BoNT-A research in the field of spasticity over the past 22 years.

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Behandeling van focale spasticiteit d.m.v. ESWT als adjuvans op Botulinetoxine: nazicht van de literatuur

Verschuere,

Oostra

2024

Tijdschr Geneesk

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Treatment of focal spasticity using Extra-corporeal Shock Wave Therapy (ESWT) as an adjuvans on Botulinum Toxin: a review of literature Background: Spasticity is a complex problem with an impact on bodily functions, activities and participation. Botulinum toxin (BTX) is commonly known as an effective and safe therapy for focal spasticity, but needs frequent repetition with risk of tolerance. Extracorporeal Shock Wave Therapy (ESWT) is a treatment already known for its positive temporary effect on focal spasticity in monotherapy. This literature review wishes to evaluate the potential of ESWT as an adjuvant therapy to Botulinum toxin based on the hypothesis that it may prolong and enhance the therapeutic effect since ESWT influences the rheological properties of the spastic muscle, where Botulinum toxin rather affects the neural mechanisms of spasticity. Methods: review of literature. Results: 6 studies were found, with a moderate methodological quality and strongly varying protocol for the use of Botulinum toxin and ESWT, reporting of outcome variables and follow-up. Outcome variables mainly consisted of technical investigations and measurements on the level of bodily structure and functions (in accordance with the International Classification of Functioning, Disability and Health (ICF)). Side effects were described only briefly. Short term effects were mostly positive. Follow-up longer than 3 months remained unreported. Conclusion: ESWT may be an adjuvant therapy when combined with Botulinum toxin, at least in the short term. Further research is necessary, preferably set up as randomised, double-blind controlled trials with a clear and uniform protocol concerning ESWT and Botulinum toxin, with a longer lasting follow-up. Reporting on side effects and usage of quality assessments that fit the ICF framework, as well as correct usage of biostatistics herein are required.

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The effects of botulinum toxin type A combined with extracorporeal shock wave therapy on triceps spasticity in stroke patients

Cited by 3 publications

References 0 publications

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

The Role of Botulinum Toxin Type-A in Spasticity: Research Trends from a Bibliometric Analysis

Behandeling van focale spasticiteit d.m.v. ESWT als adjuvans op Botulinetoxine: nazicht van de literatuur

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