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Spasticity AND botulinum toxin

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https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#1
Katharine E Alter, Mark Gormley, Atul T Patel
As seen in this CME online activity (available at http://courses.elseviercme.com/spasticity/662e), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient's impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients' goals...
June 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28629806/prevalence-of-bleeding-complications-following-ultrasound-guided-botulinum-toxin-injections-in-patiens-on-anticoagulation-or-antiplatelet-therapy
#2
Jeffrey Lavallee, Regan Royer, Geoffrey Smith
BACKGROUND: Patients on anticoagulation or antiplatelet therapy may be at higher risk of bleeding complications following intramuscular chemodenervation injections. Musculoskeletal ultrasound may be able to reduce the risk of bleeding complications by providing real time visualization of vascular structures and post-injection monitoring. Limited data exist addressing risk of bleeding complications following ultrasound-guided botulinum neurotoxin intramuscular chemodenervation procedures in the setting of anticoagulation or antiplatelet therapy...
June 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28625615/efficacy-and-safety-of-abobotulinumtoxina-dysport%C3%A2-for-the-treatment-of-hemiparesis-in-adults-with-upper-limb-spasticity-previously-treated-with-botulinum-toxin-sub-analysis-from-a-phase-3-randomized-controlled-trial
#3
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 SETTING: 34 neurology or rehabilitation clinics in nine countries. PARTICIPANTS: Adults aged 18-80 years with hemiparesis, ≥6 months after stroke or traumatic brain injury. This analysis focused on a subgroup of subjects with previous onabotulinumtoxinA or incobotulinumtoxinA treatment (n=105 of 243 in the total trial population) in the affected limb...
June 15, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28623614/abobotulinumtoxina-a-review-in-pediatric-lower-limb-spasticity
#4
Yahiya Y Syed
AbobotulinumtoxinA (Dysport(®)) is currently the only botulinum toxin A formulation approved by the US FDA for the treatment of lower limb spasticity in pediatric patients aged ≥2 years. Intramuscular abobotulinumtoxinA was approved based on the results of a pivotal phase 3 trial in children with lower limb spasticity due to cerebral palsy. In this trial, a single treatment cycle with abobotulinumtoxinA 10-15 U/kg/leg injected into the gastrocnemius and soleus muscles significantly improved ankle plantar flexor muscle tone (primary endpoint), with abobotulinumtoxinA recipients showing a significant response to treatment relative to placebo...
June 16, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28587407/clinical-study-of-botulinum-toxin-a-injection-combined-with-spasmodic-muscle-therapeutic-instrument-on-lower-limb-spasticity-in-patients-with-stroke
#5
Xudong Ding, Li Huang, Qingsong Wang, Yanping Liu, Jing Zhong, Huaxian Chen
The clinical effect of botulinum toxin A (BTX-A) injection combined with spasmodic muscle therapeutic instrument with simple BTX-A injection was compared. Eighty patients with stroke were randomly divided into the treatment and control groups of 41 and 39 cases, respectively. The two groups of patients were given routine rehabilitation therapy. Ultrasound-guide positioning technology was used; treatment group was administered BTX-A injection combined spasmodic muscle therapeutic instrument while the control group received only BTX-A injection...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28582880/the-effect-of-botulinum-toxin-a-botox-injections-used-to-treat-limb-spasticity-on-speech-patterns-in-children-with-dysarthria-and-cerebral-palsy-a-report-of-two-cases
#6
Marilyn Seif Workinger, Raymond D Kent, Jill R Meilahn
Botulinum toxin A (Btx-A) injections are used to treat limb spasticity in children with cerebral palsy (CP) resulting in improved gross and fine motor control. This treatment has also been reported to have additional functional effects, but the effect of treatment on speech has not been reported. This report presents results of longitudinal speech evaluation of two children with CP given injections of Btx-A for treatment of limb spasticity. Speech evaluations were accomplished at baseline (date of injections) and 4- and 10-weeks post-injections...
May 19, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/28566161/long-term-safety-of-repeated-high-doses-of-incobotulinumtoxina-injections-for-the-treatment-of-upper-and-lower-limb-spasticity-after-stroke
#7
Andrea Santamato, Francesco Panza, Domenico Intiso, Alessio Baricich, Alessandro Picelli, Nicola Smania, Francesca Fortunato, Davide Seripa, Pietro Fiore, Maurizio Ranieri
Current guidelines suggested a dosage up to 600units (U) of botulinum toxin type A (BoNT-A) (onabotulinumtoxinA or incobotulinumtoxinA) in reducing spastic hypertonia with low prevalence of complications, although a growing body of evidence showed efficacy with the use of high doses (>800U). The available evidence mainly referred to a single set of injections evaluating the efficacy and safety of the neurotoxin 30days after the treatment. In a prospective, non-randomized, open-label study, we studied the safety of repeated higher doses of incobotulinumtoxinA in post-stroke upper and lower limb spasticity...
July 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28539691/goals-set-by-patients-using-the-icf-model-before-receiving-botulinum-injections-and-their-relation-to-spasticity-distribution
#8
Kevin Choi, Jaclyn Peters, Andrew Tri, Elizabeth Chapman, Ayako Sasaki, Farooq Ismail, Chris Boulias, Shannon Reid, Chetan P Phadke
Purpose: Goal Attainment Scaling (GAS) is used to assess functional gains in response to treatment. Specific characteristics of the functional goals set by individuals receiving botulinum toxin type A (BoNTA) injections for spasticity management are unknown. The primary objectives of this study were to describe the characteristics of the goals set by patients before receiving BoNTA injections using the International Classification of Functioning, Disability and Health (ICF) and to determine whether the pattern of spasticity distribution affected the goals set...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/28530017/mechanical-stress-by-spasticity-accelerates-fracture-healing-after-spinal-cord-injury
#9
Naoyoshi Sakitani, Hiroyuki Iwasawa, Masato Nomura, Yasushi Miura, Hiroshi Kuroki, Junya Ozawa, Hideki Moriyama
Accelerated fracture healing in patients with spinal cord injuries (SCI) is often encountered in clinical practice. However, there is no distinct evidence in the accelerated fracture healing, and the mechanisms of accelerated fracture healing in SCI are poorly understood. We aimed to determine whether SCI accelerated fracture healing in morphology and strength, to characterize the healing process with SCI, and to clarify the factors responsible for accelerated fracture healing. In total, 39 male Wistar rats were randomly divided into healthy control without intervention, SCI only, fracture with SCI, botulinum toxin (BTX) A-treated fracture with SCI, and propranolol-treated fracture with SCI groups...
May 22, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28520679/knee-recurvatum-in-children-with-spastic-diplegic-cerebral-palsy
#10
Jeremy Bauer, K Patrick Do, Jing Feng, Rosemary Pierce, Michael Aiona
BACKGROUND: The purpose of this study is to determine which factors drive patients with diplegic cerebral palsy to walk without knee recurvatum despite hyperextension of the knee on physical examination. METHODS: A retrospective review was conducted of all data collected in the Gait Analysis Laboratory between 1999 and 2014. Patients with spastic diplegic cerebral palsy and at least 5 degrees of knee extension on clinical examination were identified for the study...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28497442/-myths-and-evidence-on-the-use-of-botulinum-toxin-spasticity-in-adults-and-in-children-with-cerebral-palsy
#11
J C Martinez-Castrillo, J L Pena-Segura, P Sanz-Cartagena, X Alonso-Curco, J M Arbelo-Gonzalez, G Arriola-Pereda, M D Coll-Bosch, J A Conejero-Casares, A Garcia-Ribes, S Jauma-Classen, J Pagonabarraga, J Vidal-Valls, P J Garcia-Ruiz
INTRODUCTION: Spasticity is a medical problem with a high incidence that significantly impact on the quality of life of patients and their families. AIM: To analyze and to answer different questions about the use of botulinum toxin type A (BTA) in our clinical practice. DEVELOPMENT: A group of experts in neurology develop a list of topics related with the use of BTA. Two big groups were considered: spasticity in adults and in children with cerebral palsy...
May 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28481738/outcomes-of-botulinum-toxin-type-a-for-equinovarus-deformity-in-patients-with-cva-a-case-series
#12
Priya Karakkattil, Elaine Trudelle-Jackson, Heather Hilliard Brown, Patrick Hammontree, Mary Okolo
BACKGROUND: There is evidence that Botulinum Toxin-A (BTX-A) reduces focal spasticity associated with equinovarus to improve gait in patients poststroke. However, there is little research examining whether gait improvements are maintained after the effectiveness period of BTX-A injections. The purpose of this observational study was to determine whether there was a difference in gait parameters in three patients before BTX-A injection versus four and ten weeks after. CASE SERIES: Three women, ages 63, 60, and 42 postischemic stroke with hemiparesis and equinovarus underwent measurements for: plantar flexor spasticity, ankle dorsiflexion ROM, temporal-spatial gait parameters, and gait endurance...
May 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28478825/do-flexible-inter-injection-intervals-improve-the-effects-of-botulinum-toxin-a-treatment-in-reducing-impairment-and-disability-in-patients-with-spasticity
#13
Carlo Trompetto, Lucio Marinelli, Laura Mori, Luca Puce, Elisa Pelosin, Carlo Serrati, Francesco Fattapposta, Steno Rinalduzzi, Giovanni Abbruzzese, Antonio Currà
In patients treated with botulinum toxin-A (BoNT-A), toxin-directed antibody formation was related to the dosage and frequency of injections, leading to the empirical adoption of minimum time intervals between injections of 3months or longer. However, recent data suggest that low immunogenicity of current BoNT-A preparations could allow more frequent injections. Our hypothesis is that a short time interval between injections may be safe and effective in reducing upper limb spasticity and related disability...
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28471469/influence-of-physician-empathy-on-the-outcome-of-botulinum-toxin-treatment-for-upper-limb-spasticity-in-patients-with-chronic-stroke-a-cohort-study
#14
Alessandro Picelli, Gabriella Vallies, Elena Chemello, Alessandro Gavras, Paola Castellazzi, Andrea Meschieri, Anna Serina, Marialuisa Gandolfi, Alessio Baricich, Andrea Santamato, Carlo Cisari, Nicola Smania
OBJECTIVE: To examine the relationship between patient-rated physician empathy and outcome of botulinum toxin treatment for post-stroke upper limb spasticity. DESIGN: Cohort study. SUBJECTS: Twenty chronic stroke patients with upper limb spasticity. METHODS: All patients received incobotulinumtoxinA injection in at least one muscle for each of the following patterns: flexed elbow, flexed wrist and clenched fist. Each treatment was performed by 1 of 5 physiatrists with equivalent clinical experience...
April 27, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28465830/economics-of-botulinum-toxin-therapy-influence-of-the-abobotulinumtoxina-package-size-on-the-costs-of-botulinum-toxin-therapy
#15
Dirk Dressler, Fereshte Adib Saberi
BACKGROUND: AbobotulinumtoxinA (Dysport®) was distributed for many years in vials containing 500MU (D500). Recently a new 300MU vial (D300) was additionally introduced (introduction). We wanted to explore whether more differentiated package sizes allow for more economic use of Dysport® in a large neurological botulinum toxin (BT) outpatient clinic. METHODS: The study followed a retrospective chart review design based on our digital BT therapy data bank. All patients receiving Dysport® exclusively in a constant dose during the observation period (introduction ± 7 months) were included...
2017: Journal of Clinical Movement Disorders
https://www.readbyqxmd.com/read/28451697/assessment-and-treatment-of-spastic-equinovarus-foot-after-stroke-guidance-from-the-mont-godinne-interdisciplinary-group
#16
Thierry Deltombe, Delphine Wautier, Philippe De Cloedt, Michèle Fostier, Thierry Gustin
OBJECTIVE: To present interdisciplinary practical guidance for the assessment and treatment of spastic equinovarus foot after stroke. RESULTS: Clinical examination and diagnostic nerve block with anaesthetics determine the relative role of the factors leading to spastic equinovarus foot after stroke: calf spasticity, triceps surae - Achilles tendon complex shortening and dorsiflexor muscles weakness and/or imbalance. Diagnostic nerve block is a mandatory step in determining the cause(s) of, and the most appropriate treatment(s) for, spastic equinovarus foot...
April 26, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28421032/spasticity-motor-recovery-and-neural-plasticity-after-stroke
#17
REVIEW
Sheng Li
Spasticity and weakness (spastic paresis) are the primary motor impairments after stroke and impose significant challenges for treatment and patient care. Spasticity emerges and disappears in the course of complete motor recovery. Spasticity and motor recovery are both related to neural plasticity after stroke. However, the relation between the two remains poorly understood among clinicians and researchers. Recovery of strength and motor function is mainly attributed to cortical plastic reorganization in the early recovery phase, while reticulospinal (RS) hyperexcitability as a result of maladaptive plasticity, is the most plausible mechanism for poststroke spasticity...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28393669/serial-casting-as-an-adjunct-to-botulinum-toxin-type-a-treatment-in-children-with-cerebral-palsy-and-spastic-paraparesis-with-scissoring-of-the-lower-extremities
#18
Alper I Dai, Abdullah T Demiryürek
The purpose of this study was to examine whether combination therapy of serial casting and botulinum toxin type A injection can further enhance the effects of botulinum toxin type A in children with cerebral palsy with scissoring of both legs. This study was a prospective and randomized trial. The children were divided into 2 groups, one of which received serial casting after botulinum toxin type A (n = 40), and the other which only received botulinum toxin type A (n = 40). Serial casting started 3 weeks after the botulinum toxin type A...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28385185/antibody-responses-to-botulinum-neurotoxin-type-a-of-toxin-treated-spastic-equinus-children-with-cerebral-palsy-a-randomized-clinical-trial-comparing-two-injection-schedules
#19
Minako Oshima, Philip Deitiker, Tandy Hastings-Ison, K Roger Aoki, H Kerr Graham, M Zouhair Atassi
We have conducted a 26-month-long comparative study involving young patients (2-6years old) with a clinical diagnosis of spastic equinus secondary to cerebral palsy who have been treated with BoNT/A (BOTOX®, Allergan) tri-annually or annually. Serum samples were obtained to determine the presence or absence of blocking antibodies (Abs) by a mouse protection assay (MPA) and levels of anti-BoNT/A Abs by radioimmune assay (RIA). HLA DQ alleles were typed using blood samples to determine the possible association of certain HLA type(s) with the disease or with the Ab status...
May 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28382814/sonographic-guide-for-botulinum-toxin-injections-of-the-lower-limb-euro-musculus-usprm-spasticity-approach
#20
Bayram Kaymak, Murat Kara, Fatih Tok, Ulaşlı Am, Öztürk Gt, Ke-Vin Chang, Ming-Yen Hsiao, Chen-Yu Hung, Arzu Y On, Levent Özçakar
The pertinent literature lacks overt technical data for optimal lower limb muscle botulinum toxin injections using ultrasound (US) imaging. Therefore, this guide is prepared for the commonly injected muscles of the lower limb and the pelvic girdle mainly in spasticity. It includes clinical information, anatomical description and explanation regarding the ultrasound imaging of several muscles. The figures have been organized to orient the readers on the innervation zones, injection sites, probe positionings and the US images simultaneously...
April 4, 2017: European Journal of Physical and Rehabilitation Medicine
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