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Post stroke spasticity, botulinum

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https://www.readbyqxmd.com/read/29978276/the-effects-of-different-injection-techniques-of-botulinum-toxin-a-in-post-stroke-patients-with-plantar-flexor-spasticity
#1
Isil Fazilet Turna, Belgin Erhan, Necibe Berrin Gunduz, Onder Turna
The purpose of this study was to compare the effects of different injection technique guidance with electrical stimulation (ES) vs ultrasonography (USG) of botulinum toxin A injection (BoNT A) in post-stroke patients with plantar flexor spasticity. Forty chronic post-stroke patients with plantar flexor spasticity and who were able to walk were included in the study. They were randomized into two groups: in 20 patients the BoNT A injection was applied with the guidance of ES and in 20 patients with the guidance of USG by the same physician...
July 5, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29963551/changes-in-the-neural-and-non-neural-related-properties-of-the-spastic-wrist-flexors-after-treatment-with-botulinum-toxin-a-in-post-stroke-subjects-an-optimization-study
#2
Ruoli Wang, Johan Gäverth, Pawel A Herman
Quantifying neural and non-neural contributions to the joint resistance in spasticity is essential for a better evaluation of different intervention strategies such as botulinum toxin A (BoTN-A). However, direct measurement of muscle mechanical properties and spasticity-related parameters in humans is extremely challenging. The aim of this study was to use a previously developed musculoskeletal model and optimization scheme to evaluate the changes of neural and non-neural related properties of the spastic wrist flexors during passive wrist extension after BoTN-A injection...
2018: Frontiers in Bioengineering and Biotechnology
https://www.readbyqxmd.com/read/29915932/cost-effectiveness-of-long-term-incobotulinumtoxin-a-treatment-in-the-management-of-post-stroke-spasticity-of-the-upper-limb-from-the-australian-payer-perspective
#3
Koji Makino, Dominic Tilden, Carmel Guarnieri, Mia Mudge, Ian J Baguley
BACKGROUND: In Australia, the reimbursement of botulinum neurotoxin-A (BoNT-A) on the Pharmaceutical Benefits Scheme for the treatment of moderate to severe spasticity of the upper limb following a stroke (PSS-UL) is restricted to four treatment cycles per upper limb per lifetime. This analysis examined the cost effectiveness of extending the treatment beyond four treatments among patients with an adequate response to previous treatment cycles. METHODS: A Markov state transition model was developed to perform a cost-utility analysis of extending the use of incobotulinumtoxin-A beyond the current restriction of four treatment cycles among patients who have shown a successful response in previous treatment cycles ('known responders')...
June 18, 2018: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29857568/botulinum-toxin-for-central-neuropathic-pain
#4
REVIEW
Jihye Park, Myung Eun Chung
Botulinum toxin (BTX) is widely used to treat muscle spasticity by acting on motor neurons. Recently, studies of the effects of BTX on sensory nerves have been reported and several studies have been conducted to evaluate its effects on peripheral and central neuropathic pain. Central neuropathic pain includes spinal cord injury-related neuropathic pain, post-stroke shoulder pain, multiple sclerosis-related pain, and complex regional pain syndrome. This article reviews the mechanism of central neuropathic pain and assesses the effect of BTX on central neuropathic pain...
June 1, 2018: Toxins
https://www.readbyqxmd.com/read/29808523/effects-of-robot-assisted-gait-training-in-chronic-stroke-patients-treated-by-botulinum-toxin-a-a-pivotal-study
#5
Dursun Erbil, Gokbel Tugba, Topcu Hasan Murat, Akarsu Melike, Akyüz Merve, Karacan Cagla, Çiftçi Can Mehmetali, Öztürk Akay, Dursun Nigar
OBJECTIVE: To investigate combined effects of robot-assisted training (RAT) and physical therapy versus physical therapy only on balance and gait function of chronic stroke patients after botulinum toxin-A (BoNT-A) treatment. METHODS: Forty-eight chronic stroke patients, received BoNT-A treatment for lower extremity spastic muscles, were randomly assigned to RAT (n = 32) and control (n = 16) groups in a 2:1 ratio. RAT group received 30 min of RAT (RoboGait®) plus 60 min of physical therapy, whereas controls received 90 min of physical therapy for 3 weeks during weekdays...
July 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/29796293/intensive-therapy-after-botulinum-toxin-in-adults-with-spasticity-after-stroke-versus-botulinum-toxin-alone-or-therapy-alone-a-pilot-feasibility-randomized-trial
#6
Natasha A Lannin, Louise Ada, Tamina Levy, Coralie English, Julie Ratcliffe, Doungkamol Sindhusake, Maria Crotty
Background: Botulinum toxin-A is provided for adults with post-stroke spasticity. Following injection, there is a variation in the rehabilitation therapy type and amount provided. The purpose of this study was to determine if it is feasible to add intensive therapy to botulinum toxin-A injections for adults with spasticity and whether it is likely to be beneficial. Methods: Randomized trial with concealed allocation, assessor blinding, and intention to treat analysis...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29740633/effect-of-early-use-of-abobotulinumtoxina-after-stroke-on-spasticity-progression-protocol-for-a-randomised-controlled-pilot-study-in-adult-subjects-with-moderate-to-severe-upper-limb-spasticity-ontime-pilot
#7
Keng He Kong, Jovita Balcaitiene, Hugues Berard, Pascal Maisonobe, Khean Jin Goh, Witsanu Kumthornthip, Raymond L Rosales
Introduction: Approximately 15 million people suffer a stroke annually, up to 40% of which may develop spasticity, which can result in impaired limb function, pain and associated involuntary movements affecting motor control.Robust clinical data on spasticity progression, associated symptoms development and functional impairment is scarce. Additionally, maximal duration of muscle tone reduction following botulinum toxin type A (BoNT-A) injections remains undetermined. The ONTIME pilot study aims to explore these issues and evaluate whether abobotulinumtoxinA 500 U (Dysport® ; Ipsen) administered intramuscularly within 12 weeks following stroke delays the appearance or progression of symptomatic (disabling) upper limb spasticity (ULS)...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29530514/functional-outcomes-following-ultrasound-guided-botulinum-toxin-type-a-injections-to-reduce-spastic-equinovarus-in-adult-post-stroke-patients
#8
Semra Aktürk, Raikan Büyükavcı, Yüksel Ersoy
OBJECTIVE: The aim of this study is to identify the effect on spasticity and walking of US-guided botulinum toxin type A (BoNT-A) injections administered to improve equinovarus walking pattern commonly observed in patients after stroke. MATERIAL AND METHOD: Twenty-three patients with post-stroke spastic equinovarus deformity were recruited. The US-guided BoNT-A injections were administered into the spastic muscles (including gastrocnemius; GK, soleus; S and tibialis posterior; TP) using a specific approach, and all of the patients were enrolled in rehabilitation programmes after the injections...
May 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29510234/the-effects-of-botulinum-toxin-injections-on-plantar-flexor-spasticity-in-different-phases-after-stroke-a-secondary-analysis-from-a-double-blind-randomized-trial
#9
Hyun-Mi Oh, Geun-Young Park, Young Min Choi, Hyung Jung Koo, Yongjun Jang, Sun Im
BACKGROUND: There are no guidelines on the ideal time to inject botulinum toxin type A (BT-A) for lower leg spasticity in stroke patients. An early injection may produce unwanted weakness, interfering with gait recovery. OBJECTIVE: To evaluate whether the outcomes after BT-A injection for plantarflexion spasticity can be different according to stroke chronicity. DESIGN: A secondary analysis study from a double-blinded, randomized trial with group reclassification according to stroke chronicity...
March 3, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29422486/evaluating-the-functional-outcomes-of-ultrasound-guided-botulinum-toxin-type-a-injections-using-the-euro-musculus-approach-for-upper-limb-spasticity-treatment-in-post-stroke-patients-an-observational-study
#10
Raikan Buyukavci, Semra Akturk, Yüksel Ersoy
BACKGROUND: Ultrasound-guided botulinum toxin type A injection is an effective treatment for spasticity. Euro-musculus spasticity approach is a new method for administering injections to the correct point of the correct muscle. The clinical outcomes of this practical approach is not yet available in the literature. AIM: The purpose of this study was to evaluate the effects on spasticity and the functional outcomes of ultrasound guided botulinum toxin type A injections via the Euro-musculus spasticity approach to treat upper limb spasticity in post-stroke patients...
February 7, 2018: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29322885/analysis-of-a-15-years-experience-in-including-shoulder-muscles-when-treating-upper-limb-spasticity-post-stroke-with-botulinum-toxin-type-a
#11
Maria Pais de Carvalho, Daniela Pinto, Melissa Gorayeb, Jorge Jacinto
Background Botulinum toxin type-A (BoNTA) is a recognized treatment for upper limb spasticity (ULS) after stroke, but there aren't many studies analyzing its effect in shoulder muscles. Objective To evaluate the efficacy of BoNTA injections for ULS, when shoulder muscles are included. Methods A cross-sectional study. Data from clinical forms of outpatients, treated at a Rehabilitation Center (2001-2016). Analyzes: goals of treatment; demographic characteristics/goal; treatment success, using Goal Attainment Scaling...
April 2018: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/29304876/a-systematic-review-efficacy-of-botulinum-toxin-in-walking-and-quality-of-life-in-post-stroke-lower-limb-spasticity
#12
Anupam Datta Gupta, Wing Hong Chu, Stuart Howell, Subhojit Chakraborty, Simon Koblar, Renuka Visvanathan, Ian Cameron, David Wilson
BACKGROUND: Improved walking is one of the highest priorities in people living with stroke. Post-stroke lower limb spasticity (PSLLS) impedes walking and quality of life (QOL). The understanding of the evidence of improved walking and QOL following botulinum toxin (BoNTA) injection is not clear. We performed a systematic review of the randomized control trials (RCT) to evaluate the effectiveness of BoNTA injection on walking and QOL in PSLLS. METHODS: We searched PubMed, Web of Science, Embase, CINAHL, ProQuest Thesis and Dissertation checks, Google Scholar, WHO International Clinical Trial Registry Platform, ClinicalTrials...
January 5, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29156545/ultrasonographic-evaluation-of-botulinum-toxin-injection-site-for-the-medial-approach-to-tibialis-posterior-muscle-in-chronic-stroke-patients-with-spastic-equinovarus-foot-an-observational-study
#13
MULTICENTER STUDY
Alessandro Picelli, Alessio Baricich, Elena Chemello, Nicola Smania, Carlo Cisari, Marialuisa Gandolfi, Nicoletta Cinone, Maurizio Ranieri, Andrea Santamato
The tibialis posterior muscle is a frequent target for injection of botulinum toxin during the management of spastic equinovarus foot in adults with post-stroke spasticity. Although it is deep-seated, the needle insertion into the tibialis posterior muscle is usually performed using anatomical landmarks and safety information obtained from healthy subjects and cadavers. Our aim was to evaluate the botulinum toxin injection site for the medial approach to the tibialis posterior muscle in chronic stroke patients with spastic equinovarus foot...
November 18, 2017: Toxins
https://www.readbyqxmd.com/read/29126361/a-survey-of-the-current-practice-of-intramuscular-botulinum-toxin-injections-for-hemiplegic-shoulder-pain-in-the-uk
#14
Richard J Holmes, Louise A Connell
PURPOSE: To describe the current UK practice for the use of intramuscular Botulinum Toxin type A injections to treat hemiplegic shoulder pain. METHOD: A UK-based cross-sectional study using an online survey. Participants (n = 68) were medical and non-medical practitioners recruited via the membership of the British Society for Rehabilitation Medicine and the British Neurotoxin Network. Data was analysed using descriptive statistics and content analysis. RESULTS: The majority of respondents would consider Botulinum Toxin type A for hemiplegic shoulder pain (86...
November 10, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29116410/botulinum-toxin-therapy-in-patients-with-oral-anticoagulation-is-it-safe
#15
Christoph Schrader, Markus Ebke, Fereshte Adib Saberi, Dirk Dressler
When used therapeutically, botulinum toxin (BT) has to be injected into its target tissues. All manufacturers warn not to do so in patients with oral anticoagulation to avoid haematoma. We wanted to study the haematoma frequency (HF) in patients with anticoagulation receiving BT therapy. 32 patients (16 females, 16 males, age 69.3 ± 10.0 years) with blepharospasm (n = 6), hemifacial spasm (n = 8), post-stroke spasticity (n = 16), and cervical dystonia (n = 2) received BT therapy (needle size 27G, post-injection tissue compression) whilst on anticoagulation (anticoagulation group, AG)...
February 2018: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28985683/effects-of-botulinum-toxin-a-therapy-and-multidisciplinary-rehabilitation-on-lower-limb-spasticity-classified-by-spastic-muscle-echo-intensity-in-post-stroke-patients
#16
Takatoshi Hara, Masahiro Abo, Hiroyoshi Hara, Kazushige Kobayashi, Yusuke Shimamoto, Yamato Shibata, Nobuyuki Sasaki, Naoki Yamada, Masachika Niimi
OBJECTIVES: The purpose of the present study was to investigate retrospectively the relationship between botulinum toxin type A plus multidisciplinary rehabilitation and muscle echo intensity in post-stroke patients with spasticity. The primary aim was to investigate whether the effects of the intervention on the improvement of spasticity depend on muscle echo intensity, and the secondary aim was to investigate whether the motor function of the lower limbs depends on muscle echo intensity...
May 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28877510/heart-rate-variability-modifications-induced-by-high-doses-of-incobotulinumtoxina-and-onabotulinumtoxina-in-hemiplegic-chronic-stroke-patients-a-single-blind-randomized-controlled-crossover-pilot-study
#17
Alessio Baricich, Elisa Grana, Stefano Carda, Andrea Santamato, Claudio Molinari, Carlo Cisari, Marco Invernizzi
BACKGROUND: Botulinum toxin type A is a valid and safe treatment for focal spasticity, with documented effects on both sympathetic and parasympathetic systems. Heart rate variability can provide detailed information about the control of the autonomic nervous system on cardiovascular activities. Previous studies in literature showed no significant changes in Heart Rate Variability with doses >600 U of incobotulinumtoxinA in chronic post stroke spastic patients; however, at present time, these results have not been confirmed with doses >600 U of onabotulinumtoxinA...
November 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28726023/benefits-and-risks-of-non-approved-injection-regimens-for-botulinum-toxins-in-spasticity
#18
REVIEW
Andrea Santamato, Francesco Panza
Spasticity with muscle paresis and loss of dexterity is a common feature of upper motor neuron syndrome due to injuries or the pyramidal tract in several neurological conditions. Botulinum toxin type A has been considered the gold standard treatment for spasticity and movement disorders, with efficacy, reversibility, and low prevalence of complications. During the last 30 years, thousands of studies of its use have been performed, but few guidelines are available. Therefore, there is great variability in both the doses and intervals of administration and the approaches taken by clinicians with considerable experience in spasticity and movement disorder treatment...
September 2017: Drugs
https://www.readbyqxmd.com/read/28676142/the-italian-real-life-post-stroke-spasticity-survey-unmet-needs-in-the-management-of-spasticity-with-botulinum-toxin-type-a
#19
A Picelli, A Baricich, C Cisari, Stefano Paolucci, Nicola Smania, Giorgio Sandrini
The present national survey seeking to identify unmet needs in the management of spasticity with botulinum toxin type A focused on the use of OnabotulinumoxinA, since this is the brand with the widest range of licensed indications in Italy. Physicians from twenty-four Italian neurorehabilitation units compiled a questionnaire about "real-life" post-stroke spasticity management. OnabotulinumtoxinA was reported to be used in the following average doses: upper limb 316.7 ± 79.1 units; lower limb 327...
April 2017: Functional Neurology
https://www.readbyqxmd.com/read/28625615/efficacy-and-safety-of-abobotulinumtoxina-dysport-for-the-treatment-of-hemiparesis-in-adults-with-upper-limb-spasticity-previously-treated-with-botulinum-toxin-subanalysis-from-a-phase-3-randomized-controlled-trial
#20
Christina Marciniak, Peter McAllister, Heather Walker, Allison Brashear, Steven Edgley, Thierry Deltombe, Svetlana Khatkova, Marta Banach, Fatma Gul, Claire Vilain, Philippe Picaut, Anne-Sophie Grandoulier, Jean-Michel Gracies
OBJECTIVE: To assess the efficacy and safety of abobotulinumtoxinA in adults with upper limb spasticity previously treated with botulinum toxin A (BoNT-A). DESIGN: A post hoc analysis from a Phase 3, prospective, double-blind, randomized, placebo-controlled study (NCT01313299). SETTING: A total of 34 neurology or rehabilitation clinics in 9 countries. PARTICIPANTS: Adults aged 18-80 years with hemiparesis, ≥6 months after stroke or traumatic brain injury...
December 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
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