The use of botulinum toxin type A in the management of adult‐onset focal spasticity: A survey of Australian allied health professionals

Williams, Gavin; Olver, John; Graaff, Stephen de; Singer, Barbara

doi:10.1111/j.1440-1630.2012.01027.x

Cited by 11 publications

(16 citation statements)

References 19 publications

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“…Many non-aesthetic ophthalmic uses of Botulinum toxin have been identified, including focal spasticity,[11] overactive bladder,[12] total painful joint arthroplasty[13] and lacrimal hypersecretion syndrome. [14] Sahlin et al .…”

Section: Introductionmentioning

confidence: 99%

Botulinum neurotoxin type A versus punctal plug insertion in the management of dry eye disease

Bukhari¹

2014

Oman J Ophthalmol

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Purpose:To compare the efficacies of punctal plug insertion and Botulinum toxin injection in dry eye disease not responding to topical medications.Materials and Methods:A non-controlled randomized clinical trial of two parallel groups of 60 dry eye patients seen in the clinic not responding to topical medications were divided into two groups. One group received punctal plugs and the other group received Botulinum toxin injections to prevent lacrimal tear drainage.Results:Of a total of 36 patients with a mean age of 44.5 years who received punctal plugs, 50% of them experienced improvements in the clinical manifestations of their disease. 12/36 (33.3%) developed plug extrusion, and 6/36 (16.7%) patients developed conjunctival erosions with irritation that necessitated plug removal within one week of insertion. A total of 24 patients with a mean age of 47.5 years received injections of Botulinum toxin. Of these, 83.3% had improvement in all of the clinical manifestations of dry eye. 4/24 (16.7%) had no improvement in the degrees to which they experienced foreign body sensations, 33.3% reported shampoo entering the eye while showering. All of the patients who received Botulinum toxin injections were satisfied with the results of their treatment, whereas only 72.3% of the patients who received punctal plugs were satisfied with their results.Conclusion:Botulinum neurotoxin A injections can be a very good alternative to punctal plugs in improving the clinical manifestations of dry eye disease They are associated with the development of fewer and milder complications and with higher levels of patient satisfaction.

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Section: Introductionmentioning

confidence: 99%

Botulinum neurotoxin type A versus punctal plug insertion in the management of dry eye disease

Bukhari¹

2014

Oman J Ophthalmol

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“…Goal types can differ in frequency depending on spasticity recovery stage (Royal College of Physicians et al . ; Williams et al ., ). In the early months of recovery, the most common goal for BoNT‐A treatment is active functional recovery, but in chronic spasticity management it is passive function.…”

Section: Introductionmentioning

confidence: 97%

“…Multidisciplinary rehabilitation is recommended (AFRM, ). Therapy treatment for BoNT‐A patients includes physical modalities (such as sustained stretch using serial casting, orthoses, taping/strapping), strengthening, forced use motor training (constraint‐induced movement therapy), repetitive task‐specific practice and/or mental practice, ‘movement based therapy’, home exercise programmes, electrical stimulation to agonist and injected muscles and adaptation of activities or the environment to prevent and minimise adverse impact of spasticity on function (Demetrios et al ., ; Katalinic et al ., 2010; Williams et al ., ). Currently, there are no modality‐specific guidelines for treatment type, frequency or duration, nor is much known about current practice.…”

Section: Introductionmentioning

confidence: 97%

“…To date, little information about processes of care as evidenced by practice patterns is available (e.g. Williams, Olver, De Graff & Singer, is the only study to date on Australian therapy BoNT‐A related practice); and as yet practice guidelines for BoNT‐A related therapy assessment and treatment have not been developed (Sun et al ., ). Evidence regarding post‐stroke treatment effects in multidisciplinary spasticity management is also limited (Demetrios, Khan, Turner‐Stokes, Brand & McSweeney, ).…”

Section: Introductionmentioning

confidence: 99%

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Upper limb spasticity management for patients who have received Botulinum Toxin A injection: Australian therapy practice

Cusick

Lannin

Kinnear

2015

Aus Occup Therapy J

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Background/aim To describe Australian physiotherapy and occupational therapy practice for patients who receive upper-limb Botulinum Toxin-A (BoNT-A). Method Anonymous online survey asking about practice experience. Convenience sample of 128 BoNT-A experienced occupational therapists and physiotherapists. Results The primary work setting was multidisciplinary inpatient or outpatient rehabilitation services where therapists had automatic referral to BoNT-A patients. Patients expected BoNT-A to improve functional movement, reduce hypertonicity, increase passive range, reduce pain, improve appearance and hand hygiene. Most patients were injected in multidisciplinary public hospital clinics and had median 2 pre-injection (range 0-30) and 8 post-injection (range 0-50) therapy sessions. Biceps, flexor digitorum profundus/superficialis and brachoradialis were most frequently injected. Injectors used therapist assessment information to select sites 68% of the time; only 44% of services had assessment protocols. Standardised therapy assessments examined motor performance, pain and function in that order of frequency. The greater the awareness and perceived relevance of an assessment the more often therapists used it. All therapists set goals, most collaboratively, and these mirrored patient expectations. The most common treatments were stretch, task-specific functional training, strength training and home programmes. Conclusion While trends in Australian assessment, goals and treatment practice were observed, greater consistency could be achieved if therapy practice guidelines existed. The gap is exacerbated by the absence of Australian BoNT-A organisation and process of care spasticity management guidelines. This creates an environment where practice variability is inevitable. Recommendations to improve local service quality are made.

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“…Practice guidelines also recommend the use of standardised assessments to measure impairment, activity and participation dimensions of performance relevant to everyday real life [4, 6, 10, 11]. Although most rehabilitation clinicians measure treatment outcomes [12], evidence suggests that many have limited awareness of the range of assessments available [13]. Those who do use assessment use predominantly impairment-based measures—few use measures that capture activity or participation performance [6, 14].…”

Section: Introductionmentioning

confidence: 99%

A systematic review protocol to evaluate the psychometric properties of measures of function within adult neuro-rehabilitation

et al. 2015

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BackgroundSpasticity in the upper limb is common after acquired brain impairment and may have a significant impact on the ability to perform meaningful daily activities. Traditionally, outcome measurement in spasticity rehabilitation has focused on impairment, however, improvements in impairments do not necessarily translate to improvements in an individual’s ability to perform activities or engage in life roles. There is an increasing need for outcome measures that capture change in activity performance and life participation.Methods/DesignWe will conduct a systematic review of the psychometric properties of instruments used to measure upper limb functional outcomes (activity performance and participation) in patients with spasticity. Assessments (n = 27) will be identified from a recently published systematic review of assessments that measure upper limb function in neurological rehabilitation for adults with focal spasticity, and a systematic review of each assessment will then be conducted. The databases MEDLINE, CINAHL and EMBASE will be searched from inception. Search strategies will include the name of the assessment and the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) published search strategy for identifying studies of measurement properties. The methodological rigour of the testing of the psychometric quality of instruments will be undertaken using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. International Classification of Functioning, Disability and Health (ICF) definitions of impairment, activity and participation will be used for content analysis of items to determine the extent to which assessments are valid measures of activity performance and life participation. We will present a narrative synthesis on the psychometric properties and utility of all instruments and make recommendations for assessment selection in practice.DiscussionThis systematic review will present a narrative synthesis on the psychometric properties and utility of assessments used to evaluate function in adults with upper limb focal spasticity. Recommendations for assessment selection in practice will be made which will aid clinicians, managers and funding bodies to select an instrument fit for purpose. Importantly, appropriate assessment selection will provide a mechanism for capturing how applicable to everyday life the outcomes from individualised rehabilitation programs for the upper limb really are.Systematic review registrationPROSPERO CRD42014013190Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0076-5) contains supplementary material, which is available to authorized users.

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The use of botulinum toxin type A in the management of adult‐onset focal spasticity: A survey of Australian allied health professionals

Cited by 11 publications

References 19 publications

Botulinum neurotoxin type A versus punctal plug insertion in the management of dry eye disease

Botulinum neurotoxin type A versus punctal plug insertion in the management of dry eye disease

Upper limb spasticity management for patients who have received Botulinum Toxin A injection: Australian therapy practice

A systematic review protocol to evaluate the psychometric properties of measures of function within adult neuro-rehabilitation

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