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Total 62 results found since Jan 2013.

Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity.
We report the case of a 33-year-old female who had been receiving regular injections of incobotulinum toxin A due to spasticity of the right limbs after a hemorrhagic stroke. A switch was made to abobotulinum toxin A with an overall conversion ratio of 1:3.83. The patient presented contralateral upper limb paresis, especially of the deltoid muscle, in the second week post-injection. The electroneuromyography showed neuromuscular block due to botulinum toxin A. She recovered completely after eight months. A switch between different formulations of botulinum toxin type A should prompt caution when carrying out unit conv...
Source: Acta Medica Portuguesa - November 25, 2019 Category: General Medicine Tags: Acta Med Port Source Type: research

Clinical effectiveness of ultrasound guided subacromial-subdeltoid bursa injection of botulinum toxin type A in hemiplegic shoulder pain: A retrospective cohort study
Hemiplegic shoulder pain (HSP), which occurs in most patients with hemiplegia, causes considerable distress and worsens outcomes in rehabilitation. Although they have received the treatments such as anti-inflammatory drugs or physical therapy, many of the individuals remain suffering from shoulder pain 6 months after acute stroke event. In this retrospective study, we evaluated the effectiveness of ultrasound guided subacromial-subdeltoid (SASD) bursa injections with botulinum toxin type A (BoNT/A) compared to steroids for refractory HSP. The data were collected retrospectively by reviewing the patient's medical records a...
Source: Medicine - November 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Botuloscope: 1-year follow-up of upper limb post-stroke spasticity treated with botulinum toxin
ConclusionThis is the first long-term follow-up of BoNT-A treatment for upper limb spasticity involving a large cohort independent of industry. Quality of life was improved by treating upper limb spasticity with BoNT-A, even at 5 years post-stroke. Personalizing objectives of the treatment amplified its efficacy. BoNT-A was a powerful analgesic when pain was spasticity-related. Treating the spastic upper limb also improved balance and gait abilities.
Source: Annals of Physical and Rehabilitation Medicine - June 25, 2019 Category: Rehabilitation Source Type: research

Botuloscope: 1-year follow-up of upper-limb post-stroke spasticity treated with botulinum toxin
Conclusion. This is the first long-term follow-up of BoNT-A treatment for upper-limb spasticity involving a large cohort independent of industry. Quality of life was improved by treating upper-limb spasticity with BoNT-A, even at 5 years post-stroke. Personalizing objectives of the treatment amplified its efficacy. BoNT-A was a powerful analgesic when pain was spasticity-related. Treating the spastic upper limb also improved balance and gait abilities.
Source: Annals of Physical and Rehabilitation Medicine - June 22, 2019 Category: Rehabilitation Source Type: research

Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study
Conclusions. ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection.
Source: Annals of Physical and Rehabilitation Medicine - June 21, 2019 Category: Rehabilitation Source Type: research

Botulinum Toxin Modulates Posterior Parietal Cortex Activation in Post-stroke Spasticity of the Upper Limb
Post-stroke spasticity (PSS) is effectively treated with intramuscular botulinum toxin type A (BoNT-A), although the clinical improvement is likely mediated by changes at the central nervous system level. Using functional magnetic resonance imaging (fMRI) of the brain, this study aims to confirm and locate BoNT-A-related changes during motor imagery with the impaired hand in severe PSS. Temporary alterations in primary and secondary sensorimotor representation of the impaired upper limb were expected. Thirty chronic stroke patients with upper limb PSS undergoing comprehensive treatment including physiotherapy and indicat...
Source: Frontiers in Neurology - May 9, 2019 Category: Neurology Source Type: research

Pain and muscles properties modifications after botulinum toxin type A (BTX-A) and radial Extracorporeal Shock Wave (rESWT) combined treatment.
CONCLUSIONS: Radial Extracorporeal Shock Wave Therapy could be an effective physical treatment aimed at the reduction of upper and lower limbs spasticity and could lead to the improvement of trophic conditions of the spastic muscles in post-stroke. PMID: 30843498 [PubMed - as supplied by publisher]
Source: Endocrine, Metabolic and Immune Disorders Drug Targets - March 8, 2019 Category: Drugs & Pharmacology Tags: Endocr Metab Immune Disord Drug Targets Source Type: research

Botulinum Toxin Type A for the Treatment of Lower Limb Spasticity after Stroke
AbstractPost-stroke lower limb spasticity impairs balance and gait leading to reduced walking speed, often increasing wheelchair use and caregiver burden. Several studies have shown that appropriate treatments for lower limb spasticity after stroke include injections of botulinum toxin type A (BoNT-A), phenol or alcohol, surgical correction and a rehabilitation program. In the present article, we review the safety and effectiveness of BoNT-A for the treatment of lower limb spasticity after stroke, with a focus on higher doses of BoNT-A. The cumulative body of evidence coming from the randomized clinical trials and open-lab...
Source: Drugs - January 8, 2019 Category: Drugs & Pharmacology Source Type: research

A case study investigating the efficacy of two treatments, botox and SaeboFlex in reduced hand function due to flexor spasticity
Purpose: Dynamic hand splints such as Saeboflex are a promising intervention for aiding functional use of a person's hand following a stroke. If spasticity is present it can be a major limiting factor in using a Saeboflex. The purpose of this case study is to report the use of a combination of Botulinum Toxin Type A (BtxA) to reduce spasticity, prior to initiating a repetitive training rehabilitation programme with a Saeboflex.
Source: Physiotherapy - January 1, 2019 Category: Physiotherapy Authors: J.A. Benson Tags: P087 Source Type: research

Safety Profile of High-Dose Botulinum Toxin Type A in Post-Stroke Spasticity Treatment
AbstractBotulinum toxin type A (BoNT-A) is considered the gold standard for the treatment of focal post-stroke spasticity (PSS). However, a recently published study estimated that a significant percentage of patients affected by PSS could benefit from higher doses of BoNT-A than those permitted by current directives in the countries studied. Several studies have reported the use of high doses of BoNT-A in the management of patients affected by severe PSS; however, the most important adverse effect of this drug might be systemic diffusion of the toxin, which could potentially be related to its dose. Even if systemic toxicit...
Source: Clinical Drug Investigation - September 12, 2018 Category: Drugs & Pharmacology Source Type: research

The Effects of Botulinum Toxin Injections on Plantar Flexor Spasticity in Different Phases After Stroke: A Secondary Analysis From a Double-Blind, Randomized Trial
ConclusionsOur serial measurements of the outcome parameters indicated that BT-A could be expected to lead to consistent improvement in both the muscle tone and gait quality in those with plantar flexor spasticity regardless of stroke chronicity, including those injected as early as within the first 6 months.Level of EvidenceI
Source: PMandR - August 21, 2018 Category: Rehabilitation Source Type: research

Combined effects of botulinum toxin type A and repetitive transcranial magnetic stimulation with intensive motor training immediately after injection in a patient with chronic stroke: A case report
Single case report.
Source: Journal of Hand Therapy - July 16, 2018 Category: Rehabilitation Authors: Yuichi Hirakawa, Soichiro Koyama, Shigeo Tanabe, Kazuya Takeda, Tetsuya Ueda, Ikuo Motoya, Hiroaki Sakurai, Yoshikiyo Kanada, Nobutoshi Kawamura, Mami Kawamura, Junji Nagata, Tetsuo Kanno Tags: Case Report Source Type: research

Extracorporeal Shock Waves versus Botulinum Toxin Type A in the Treatment of Post-Stroke Upper Limb Spasticity – A Randomized, Noninferiority Trial
To investigate whether extracorporeal shock wave therapy (ESWT) is noninferior to botulinum toxin type A (BoNT-A) for the treatment of post-stroke upper limb spasticity.
Source: Archives of Physical Medicine and Rehabilitation - July 3, 2018 Category: Rehabilitation Authors: Yah-Ting Wu, Hui-Kung Yu, Li-Ru Chen, Chih-Ning Chang, Yi-Min Chen, Gwo-Chi Hu Source Type: research

Management of spasticity with onabotulinumtoxinA: practical guidance based on the italian real-life post-stroke spasticity survey.
Authors: Sandrini G, Baricich A, Cisari C, Paolucci S, Smania N, Picelli A Abstract The present paper provides practical guidance on the management of adult spasticity with OnabotulinumtoxinA. Advisory Board members reviewed the available evidence and discussed their personal experiences in order to address the unmet needs in the management of spasticity with botulinum toxin type A identified by the recent Italian Real-Life Post-Stroke Spasticity Survey. Stroke patients should be referred to spasticity services that have adequate facilities and multidisciplinary teams with the necessary training, competence and exp...
Source: Functional Neurology - April 12, 2018 Category: Neurology Tags: Funct Neurol Source Type: research

Botulinum Toxin Type A Treatment Combined with Intensive Rehabilitation for Gait Poststroke: A Preliminary Study
To examine the effects of botulinum toxin type A (BoNT-A) treatment combined with intensive rehabilitation for gait compared with intensive rehabilitation alone in patients with chronic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - March 30, 2018 Category: Neurology Authors: Yuki Uchiyama, Tetsuo Koyama, Yosuke Wada, Masashi Katsutani, Norihiko Kodama, Kazuhisa Domen Source Type: research

Functional outcomes following ultrasound-guided botulinum toxin type A injections to reduce spastic equinovarus in adult post-stroke patients.
CONCLUSION: Spastic equinovarus deformity observed in patients after stroke creates significant limitations in the patient's functional walking speed and distance. As a result, when BoNT-A injections accompanied by ultrasound to improve equinovarus deformity considering the innervation zones of the muscles with a specific approach are administered directly into the muscle at the correct point, we can say it provides hopeful results from a functional point of view. PMID: 29530514 [PubMed - as supplied by publisher]
Source: Toxicon - March 9, 2018 Category: Toxicology Authors: Aktürk S, Büyükavcı R, Ersoy Y Tags: Toxicon Source Type: research

The Effects of Botulinum Toxin Injections on Plantar Flexor Spasticity in Different Phases After Stroke: A Secondary Analysis From a Double-Blind, Randomized Trial
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.
Source: PM and R - March 3, 2018 Category: Rehabilitation Authors: Hyun-Mi Oh, Geun-Young Park, Young Min Choi, Hyung Jung Koo, Yongjun Jang, Sun Im Tags: Original Research Source Type: research

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.
CONCLUSIONS: Ultrasound-guided botulinum toxin type A injection via the Euro- musculus spasticity approach is a practical and effective method for administering injections to the correct point of the correct muscle. Ultrasound-guided botulinum toxin type A injections combined with rehabilitation programmes decrease spasticity and improve the upper extremity motor functions in stroke patients. CLINICAL REHABILITATION IMPACT: This new approach for ultrasound- guided botulinum toxin type A injection is very practical and effective method for upper extremity spasticity. PMID: 29422486 [PubMed - as supplied by publisher]
Source: European Journal of Physical and Rehabilitation Medicine - February 7, 2018 Category: Rehabilitation Authors: Buyukavci R, Akturk S, Ersoy Y Tags: Eur J Phys Rehabil Med Source Type: research

Teamwork and toughness: Living with cerebral palsy
Growing up in Querétaro, Mexico, María was an exceptionally bright and inquisitive child. At just 18 months old, she spoke at the level of a 6-year-old, and could even sing the tongue-twisting “Supercalifragilisticexpialidocious” song. Her parents marveled at her intelligence at such a young age, but there was something in her development that seemed off. “At 1 year, she wasn’t crawling well and had difficulty standing,” her mother, María José, recalls. “She hadn’t learned to walk by 18 months, and she would crawl by pulling her two legs at the same time — like a little bunny.” Her parents knew that s...
Source: Thrive, Children's Hospital Boston - February 2, 2018 Category: Pediatrics Authors: Connor Ertz Tags: Our Patients’ Stories cerebral palsy Cerebral Palsy Center Child and Young Adult Hip Preservation Program Dr. Benjamin Shore Dr. Donna Nimec Source Type: news

Analysis of a 15-years' experience in including shoulder muscles, when treating upper-limb spasticity post-stroke with botulinum toxin type A.
Conclusion When treating ULS, including shoulder muscles, the most frequent goals were IM, PD e MOB. The most injected muscles were SC and PM. The treatment was successful in a large percentage of cases. Achieving the PD goal was associated with greater success at other goals of treatment. BoNTA demonstrated a positive effect in controlling symptoms and improving function. PMID: 29322885 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - January 11, 2018 Category: Neurology Authors: Carvalho MP, Pinto D, Gorayeb M, Jacinto J Tags: Top Stroke Rehabil Source Type: research

Patient Registry of Spasticity Care World: Data Analysis Based on Physician Experience
Objective The aim of the study was to report physician experience–based “real-world” treatment patterns with botulinum toxin type A in patients with stroke and traumatic brain injury. Design A prospective, multicenter, international observational registry design was used. Results Six hundred twenty-seven participants with stroke and 132 participants with traumatic brain injury were assessed and treated by 17 more experienced physicians and 12 less experienced physicians. Due to the limited usage of abobotulinumtoxinA Dysport and incobotulinumtoxinA Xeomin, data were reported on onabotulinumtoxinA BOTOX only. ...
Source: American Journal of Physical Medicine and Rehabilitation - November 18, 2017 Category: Rehabilitation Tags: Original Research Articles Source Type: research

A survey of the current practice of intramuscular Botulinum toxin injections for hemiplegic shoulder pain in the UK.
CONCLUSIONS: Current UK practice of Botulinum Toxin type A injections for hemiplegic shoulder pain associated with spasticity is highly variable. There are large gaps between current practice and available evidence with regards to muscle selection and doses used. A number of areas for further investigation have been identified to progress current understanding of this intervention. Implications for rehabilitation There are wide variations in practice for this complex intervention and clinicians should consider that their individual decision-making could be based on their own beliefs rather than available evidence. Pectoral...
Source: Disability and Rehabilitation - November 10, 2017 Category: Rehabilitation Authors: Holmes RJ, Connell LA Tags: Disabil Rehabil Source Type: research

Effect of Ultrasound-Guided Injection Of Botulinum Toxin Type A for Shoulder Pain On Post-Stroke Patients
To study the effect of ultrasound-guided injection of botulinum toxin type A for shoulder pain on patients with stroke.
Source: Archives of Physical Medicine and Rehabilitation - September 24, 2017 Category: Rehabilitation Authors: Xiao Bao, Howe Liu, Hao Liu, Jiewen Tan, Ying Long, Myles Quiben Source Type: research

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.
CONCLUSIONS: Our data show that high doses (>600 U) of incobotulinumtoxinA and onabotulinumtoxinA do not influence the cardiovascular activity of the autonomic nervous system in chronic hemiplegic spastic stroke survivors. PMID: 28877510 [PubMed - as supplied by publisher]
Source: Toxicon - September 3, 2017 Category: Toxicology Authors: Baricich A, Grana E, Carda S, Santamato A, Molinari C, Cisari C, Invernizzi M Tags: Toxicon Source Type: research

Poster 307: Non-Rhythmic Recurrent Shaking After Right Basal Ganglia Stroke: A Case Report
Aaron Hanyu-Deutmeyer: My spouse/partner has a relationship with Allergan Speakers bureau, My spouse/partner has a relationship with Allergan provided Botox for injection
Source: PM and R - September 1, 2017 Category: Rehabilitation Authors: Aaron A. Hanyu-Deutmeyer, Padma K. Srigiriraju Source Type: research

Benefits and Risks of Non-Approved Injection Regimens for Botulinum Toxins in Spasticity
AbstractSpasticity 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 experi...
Source: Drugs - July 19, 2017 Category: Drugs & Pharmacology Source Type: research

The Italian real-life post-stroke spasticity survey: unmet needs in the management of spasticity with botulinum toxin type A.
Authors: Picelli A, Baricich A, Cisari C, Paolucci S, Smania N, Sandrini G Abstract 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 327.8 ± 152.3; upper and lower limb 54...
Source: Functional Neurology - July 7, 2017 Category: Neurology Tags: Funct Neurol Source Type: research

Detection of Botulinum Toxin Muscle Effect in Humans Using Magnetic Resonance Imaging: A Qualitative Case Series
Conclusions This descriptive case series is among the first attempts to quantify BTME within human muscle. Our findings are preliminary and are limited by a few inconsistencies. However, we conclude that use of magnetic resonance imaging to detect the volume of BTME is feasible and may assist researchers in modeling the spread and diffusion of BT within human muscle. Level of Evidence To be determined.
Source: PMandR - May 31, 2017 Category: Rehabilitation Source Type: research

Long-term safety of repeated high doses of incobotulinumtoxinA injections for the treatment of upper and lower limb spasticity after stroke
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.
Source: Journal of the Neurological Sciences - May 1, 2017 Category: Neurology Authors: Andrea Santamato, Francesco Panza, Domenico Intiso, Alessio Baricich, Alessandro Picelli, Nicola Smania, Francesca Fortunato, Davide Seripa, Pietro Fiore, Maurizio Ranieri Source Type: research

Efficacy and safety of Botulinum Toxin type A for upper limb spasticity after stroke or traumatic brain injury: a systematic review with meta-analysis and trial sequential analysis.
CONCLUSIONS: As compared with placebo, Botulinum Toxin type A injections have beneficial effects with improved muscle tone and well-tolerated treatment for patients with upper limb spasticity post stroke or traumatic brain injury. PMID: 27834471 [PubMed - as supplied by publisher]
Source: European Journal of Physical and Rehabilitation Medicine - November 11, 2016 Category: Rehabilitation Authors: Dong Y, Wu T, Hu X, Wang T Tags: Eur J Phys Rehabil Med Source Type: research

Combined effects of robot-assisted gait training and botulinum toxin type A effect on spastic equinus foot in patients with chronic stroke: a pilot, single blind, randomized controlled trial.
CONCLUSIONS: Our preliminary findings support the hypothesis that robot-assisted gait training does not enhance the effect of botulinum toxin type A on spastic equinus foot in patients with chronic stroke. CLINICAL REHABILITATION IMPACT: Our observations should be taken into account in daily clinical rehabilitation practice in order to develop effective treatment protocols based on the enhancement of antispastic drugs effect. PMID: 27098300 [PubMed - as supplied by publisher]
Source: European Journal of Physical and Rehabilitation Medicine - April 21, 2016 Category: Rehabilitation Authors: Picelli A, Bacciga M, Melotti C, LA Marchina E, Verzini E, Ferrari F, Pontillo A, Corradi J, Tamburin S, Saltuari L, Corradini C, Waldner A, Smania N Tags: Eur J Phys Rehabil Med Source Type: research

Comparison of Effects of Botulinum Toxin Injection Between Subacute and Chronic Stroke Patients: A Pilot Study
In conclusion, botulinum toxin injection in subacute patients was more helpful for spasticity, contracture, and function than in chronic patients. However, beneficial effects of botulinum toxin injection on spasticity and function in chronic patients were found in the assessments of the modified Tardieu scale and Fugl-Meyer scale.
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Sensorimotor Modulation by Botulinum Toxin A in Post-Stroke Arm Spasticity: Passive Hand Movement
In post-stroke spasticity, functional imaging may uncover modulation in the central sensorimotor networks associated with botulinum toxin type A (BoNT) therapy. Investigations were performed to localize brain activation changes in stroke patients treated with BoNT for upper limb spasticity using functional magnetic resonance imaging (fMRI).
Source: Journal of the Neurological Sciences - January 11, 2016 Category: Neurology Authors: Tomáš Veverka, Petr Hluštík, Pavel Hok, Pavel Otruba, Jana Zapletalová, Zbyněk Tüdös, Alois Krobot, Petr Kaňovský Source Type: research

Real-World Data And Budget Impact Analysis for Incobotulinum Toxin A and Onabotulinum Toxin A for Upper Limb Post-Stroke Spasticity At A Uk Centre
Botulinum toxins (BT) are a valuable treatment option for patients with post-stroke upper-limb spasticity (PS-ULS), which affects 33,000 patients in the UK. Xeomin (incobotulinum toxin A) and Botox (onabotulinum toxin A) are two BTs licensed for the treatment of PS-ULS. The treatment costs for Xeomin and Botox will depend on their real-world usage.
Source: Value in Health - October 23, 2015 Category: Global & Universal Authors: A Robertson, P Datta, J Kusel, S Page, J Soon Source Type: research

Plastic changes in spinal synaptic transmission following botulinum toxin A in patients with post-stroke spasticity.
CONCLUSION: Botulinum toxin treatment induces synaptic plasticity at the Ia-motoneuron synapse in post-stroke paretic patients, which suggests that the effectiveness of botulinum toxin-type A in post-stroke rehabilitation might be partly due to its central effects. PMID: 26424152 [PubMed - as supplied by publisher]
Source: Journal of Rehabilitation Medicine - October 3, 2015 Category: Rehabilitation Tags: J Rehabil Med Source Type: research

Efficacy and Safety of NABOTA in Post-stroke Upper Limb Spasticity: A phase 3 multicenter, double-blinded, randomized controlled trial
Botulinum toxin A is widely used in the clinics to reduce spasticity and improve upper limb function for post-stroke patients. Efficacy and safety of a new botulinum toxin type A, NABOTA (DWP450) in post-stroke upper limb spasticity was evaluated in comparison with Botox (Onabotulinum toxin A). A total of 197 patients with post-stroke upper limb spasticity were included in this study and randomly assigned to NABOTA group (n=99) or Botox group (n=98). Wrist flexors with modified Ashworth Scale (MAS) grade 2 or greater, and elbow flexors, thumb flexors and finger flexors with MAS 1 or greater were injected with either drug.
Source: Journal of the Neurological Sciences - July 21, 2015 Category: Neurology Authors: Hyung Seok Nam, Yoon Ghil Park, Nam-Jong Paik, Byung-Mo Oh, Min Ho Chun, Hea-Eun Yang, Dae Hyun Kim, Youbin Yi, Han Gil Seo, Kwang Dong Kim, Min Cheol Chang, Jae Hak Ryu, Shi-Uk Lee Source Type: research

Physical therapy for an adult with chronic stroke after botulinum toxin injection for spasticity: a case report.
CONCLUSIONS: This case report demonstrates that physical therapy after BoNTA injections can result in significant functional improvements for individuals with spasticity after chronic stroke that may not be possible with BoNTA injections alone. PMID: 25931655 [PubMed]
Source: Physiotherapy Canada - May 3, 2015 Category: Physiotherapy Authors: Gallagher S, Phadke CP, Ismail F, Boulias C Tags: Physiother Can Source Type: research

Cortical activation changes and improved motor function in stroke patients after focal spasticity therapy– an interventional study applying repeated fMRI
Conclusions: Comprehensive focal spasticity management was also in this study associated with brain reorganization in a “normalizing” left/right lateralization direction in addition to improved motor function. Furthermore, quantification of BOLD intensity in specified BAs showed reduced neuronal “over-activity” in the injured brain after therapy.
Source: BMC Neurology - April 11, 2015 Category: Neurology Authors: Ulla BergfeldtTomas JonssonLennart BergfeldtPer Julin Source Type: research

Employment of Higher Doses of Botulinum Toxin Type A to Reduce Spasticity After Stroke
Spasticity is a common disabling symptom for several neurological conditions. Botulinum toxin type A injection represents the gold standard treatment for focal spasticity with efficacy, reversibility, and low prevalence of complications. Current guidelines suggest a dose up to 600 units (U) of onabotulinumtoxinA/incobotulinumtoxinA or up to 1500 U of abobotulinumtoxinA to treat post-stroke spasticity to avoid important adverse effects. However, recently, higher doses of botulinum toxin type A were employed, especially in case of upper and lower limb severe spasticity.
Source: Journal of the Neurological Sciences - February 5, 2015 Category: Neurology Authors: Andrea Santamato, Maria Francesca Micello, Maurizio Ranieri, Giovanni Valeno, Antonio Albano, Alessio Baricich, Carlo Cisari, Domenico Intiso, Alberto Pilotto, Giancarlo Logroscino, Francesco Panza Source Type: research

Constraint-Induced Movement Therapy After Injection of Botulinum Toxin Type A for a Patient With Chronic Stroke: One-Year Follow-up Case Report.
DISCUSSION: The improved arm function could reflect improvements in volitional movements and coordination or speed of movements in the paretic arm that resulted from a reduction in spasticity, a reduction of learned nonuse behaviors, or use-dependent plasticity after the combination of BTX type A and constraint-induced movement therapy. If this approach proves useful in future controlled studies, this may halt the rising medical costs of the treatment of stroke. PMID: 25592185 [PubMed - as supplied by publisher]
Source: Physical Therapy - January 15, 2015 Category: Physiotherapy Authors: Amano S, Takebayashi T, Hanada K, Umeji A, Marumoto K, Furukawa K, Domen K Tags: Phys Ther Source Type: research

Accuracy of botulinum toxin type A injection into the forearm muscles of chronic stroke patients with spastic flexed wrist and clenched fist: Manual needle placement evaluated using ultrasonography.
CONCLUSION: Instrumental guidance should be used in order to achieve an acceptable accuracy of needle placement when performing botulinum toxin type A injections into the forearm muscles of chronic stroke patients with spastic flexed wrist and clenched fist. PMID: 25103251 [PubMed - in process]
Source: Journal of Rehabilitation Medicine - November 14, 2014 Category: Rehabilitation Tags: J Rehabil Med Source Type: research

Can botulinum toxin type A injection technique influence the clinical outcome of patients with post-stroke upper limb spasticity? A randomized controlled trial comparing manual needle placement and ultrasound-guided injection techniques
Botulinum toxin type A is a first-line treatment for post-stroke focal spasticity, and the accuracy in delivering the toxin to the target muscles may influence the treatment outcome. Our aim was to compare the reduction of spasticity and the related finger position at rest improvement in post-stroke patients treated with botulinum toxin type A in upper limb muscles using ultrasound guidance and manual needle placement.
Source: Journal of the Neurological Sciences - September 18, 2014 Category: Neurology Authors: Andrea Santamato, Maria Francesca Micello, Francesco Panza, Francesca Fortunato, Alessio Baricich, Carlo Cisari, Alberto Pilotto, Giancarlo Logroscino, Pietro Fiore, Maurizio Ranieri Source Type: research

Cortical activity modulation by botulinum toxin type A in patients with post-stroke arm spasticity: Real and imagined hand movement
Our aim was to use functional magnetic resonance imaging (fMRI) to compare brain activation changes due to botulinum toxin A (BoNT) application between two chronic stroke patient groups with different degree of weakness treated for upper limb spasticity.
Source: Journal of the Neurological Sciences - September 14, 2014 Category: Neurology Authors: Tomáš Veverka, Petr Hluštík, Pavel Hok, Pavel Otruba, Zbyněk Tüdös, Jana Zapletalová, Alois Krobot, Petr Kaňovský Source Type: research

Use of gait parameters to predict the effectiveness of botulinum toxin injection in the spastic Rectus Femoris muscle of stroke patients with Stiff Knee Gait.
CONCLUSION: The percentage increase in peak knee flexion in swing during fast gait before injection is a useful predictor of the increase in peak knee flexion following RF BTX-A injection in chronic stroke patients with RF spasticity. PMID: 25213306 [PubMed - as supplied by publisher]
Source: European Journal of Physical and Rehabilitation Medicine - September 12, 2014 Category: Rehabilitation Authors: Roche N, Boudarham J, Hardy A, Bonnyaud C, Bensmail D Tags: Eur J Phys Rehabil Med Source Type: research

Management of stroke patients submitted to botulinum toxin type A therapy: a Delphi survey of an Italian expert panel of specialist injectors.
CONCLUSIONS:The results of this national survey confirm that clinical experts on the use of BTX- -A therapy for spasticity after stroke agree on the need to initiate rehabilitation treatment immediately after BTX--A injection: muscle stretching exercises, eventually combined with neuromuscular electrical stimulation, may enhance the effect of BTX--A therapy. Outcome after BTX--A therapy should be assessed at repeated follow--up visits. PMID: 24963604 [PubMed - as supplied by publisher]
Source: European Journal of Physical and Rehabilitation Medicine - June 19, 2014 Category: Rehabilitation Authors: Franceschini M, Iocco M, Molteni F, Santamato A, Smania N Tags: Eur J Phys Rehabil Med Source Type: research

Adhesive taping vs. daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial.
CONCLUSIONS: Adhesive taping of wrist and finger flexor muscles appeared to enhance the effect of botulinum toxin type A therapy more than daily manual muscle stretching combined with passive articular mobilization and palmar splint. PMID: 24917588 [PubMed - as supplied by publisher]
Source: Clinical Rehabilitation - June 10, 2014 Category: Rehabilitation Authors: Santamato A, Micello MF, Panza F, Fortunato F, Picelli A, Smania N, Logroscino G, Fiore P, Ranieri M Tags: Clin Rehabil Source Type: research

Therapeutic Synergism in the Treatment of Post-stroke Arm Paresis Utilizing Botulinum Toxin, Robotic Therapy, and Constraint-induced Movement Therapy
Botulinum toxin type A (BtxA) injection, constraint-induced movement therapy (CIMT), and robotic therapy (RT) each represent promising approaches to enhance arm motor recovery after stroke. To provide more effective treatment for a 50-year-old man with severe left spastic hemiparesis, we attempted to facilitate CIMT with adaptive approaches to extend the wrist and fingers using RT for 10 consecutive weeks after BtxA injection. This combined treatment resulted in substantial improvements in arm function and the amount of arm use in activities of daily living, and may be effective for stroke patients with severe arm paresis.
Source: PM and R - May 28, 2014 Category: Rehabilitation Authors: Takashi Takebayashi, Satoru Amano, Keisuke Hanada, Atsushi Umeji, Kayoko Takahashi, Tetsuo Koyama, Kazuhisa Domen Tags: Case Presentation Source Type: research

BOTOX(R) (Botulinum Toxin Type A) Receives a Positive Opinion in Fourteen European Countries for the Treatment of Focal Spasticity of the Ankle in Adult Post Stroke Patients
This Positive Opinion Paves the Way for a Second Indication for BOTOX® in Adult Spasticity Associated with Stroke MARLOW, England, May 1, 2014 -- (Healthcare Sales & Marketing Network) --Today, Allergan Inc. announced that BOTOX® has received a... Biopharmaceuticals, RegulatoryAllergan, BOTOX, Adult Spasticity, limb spasticity, stroke
Source: HSMN NewsFeed - May 1, 2014 Category: Pharmaceuticals Source Type: news