Botulinum toxin A for treatment of upper limb spasticity following stroke: A multi-centre randomized placebo-controlled study of the effects on quality of life and other person-centred outcomes

McCrory, Paul; Turner-Stokes, Lynne; Baguley, Ian; Graaff, Stephen de; Katrak, Pesi; Sandanam, Joseph; Davies, Leo; Munns, Melinda; Hughes, A.J.

doi:10.2340/16501977-0366

Cited by 151 publications

(152 citation statements)

References 24 publications

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“…Eight trials [44][45][46][47][48][49][50][51] and four systematic reviews [53][54][55][56] were published following the start of this study in 2005. Details of our literature search strategy, methodological appraisal of the papers, overview of the studies, and a summary of the systematic reviews can be found in Appendix 1.…”

Section: Review Of the Evidence For Treating Upper Limb Spasticity Dumentioning

confidence: 99%

“…Sixteen randomised controlled trials (RCTs) [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] and five systematic reviews [52][53][54][55][56] evaluating the clinical effectiveness of botulinum toxin as a treatment for upper limb spasticity after stroke have been published. Eight trials [44][45][46][47][48][49][50][51] and four systematic reviews [53][54][55][56] were published following the start of this study in 2005.…”

Section: Review Of the Evidence For Treating Upper Limb Spasticity Dumentioning

confidence: 99%

See 1 more Smart Citation

BoTULS: a multicentre randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

Shaw

Rodgers²,

Price³

et al. 2010

Health Technol Assess

163

126

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on behalf of the BoTULS investigatorsHow to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are...

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Section: Review Of the Evidence For Treating Upper Limb Spasticity Dumentioning

confidence: 99%

Section: Review Of the Evidence For Treating Upper Limb Spasticity Dumentioning

confidence: 99%

BoTULS: a multicentre randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

Shaw

Rodgers²,

Price³

et al. 2010

Health Technol Assess

163

126

View full text Add to dashboard Cite

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“…31 Botulinum toxin type A alone was shown to be effective for reducing spasticity in several double-blind, placebocontrolled, randomized controlled trials. [8][9][10][11][12] Botulinum toxin type A was shown to be an effective treatment of painful localized contractures in RHT, even without central nervous system lesions. 32 Therefore, BoNT-A may be a useful option for painful localized contractures that do not respond to standard treatment.…”

Section: Discussionmentioning

confidence: 99%

“…4 Botulinum toxin type A has already been shown to be effective in reducing poststroke upper limb spasticity in some double-blind, placebocontrolled, randomized, controlled trials. [8][9][10][11][12] Moreover, BoNT-A has been used in conjunction with physiotherapeutics to improve function and decrease pain 13,14 and spasticity. 6,15,16 Neurodynamic mobilization (NM) is a form of manual therapy that directs force to neural structures through positioning and movement of multiple joints.…”

Section: Introductionmentioning

confidence: 99%

Botulinum toxin type A combined with neurodynamic mobilization for lower limb spasticity: a case report

Villafañe¹

2013

Journal of Chiropractic Medicine

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Objective: This case report describes a patient with severe lower limb spasticity treated with botulinum toxin type A (BoNT-A) and neurodynamic mobilization (NM). Clinical Features: An 81-year-old male patient presented with a severe spastic lower limbs after total right hip replacement and severe alcoholic polyneuropathy. After the right hip replacement, he presented with generalized spasticity, crouched posture, and a large sacral pressure sore. The severe spasticity in his knees prevented walking. Intervention and Outcome: The patient underwent combined treatment with BoNT-A and NM of the lower limb in 4 weekly applications. Evaluations were performed pretreatment, 4 weeks after the injection, and at a follow-up session 9 months after finishing treatment. We measured the following outcomes: pain by the Numerical Rating Scale, spasticity by the Modified Ashworth Scale for Grading Spasticity, acceptance and emotional reaction to the treatment by the Hospital Anxiety and Depression Scale, and functionality by ranges of motion. We found that the patient improved in all of the outcomes after treatment, and these results were maintained during the follow-up. After treatment, the patient was able to improve wound healing by properly positioning himself in bed or on his wheelchair and walking with help. At the follow-up evaluation, the results were maintained. The patient showed good acceptance and decreased anxiety/depression after treatment. Conclusion: For this patient, the combination of NM and BoNT-A treatment decreased pain and spasticity and improved joint ranges of motion.

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“…It is increasingly used as a person-centred outcome measure in research evaluations of outcome following spasticity intervention [16][17][18][19][20] , and is recommended as a method of recording patient-reported outcomes in guidelines for management of spasticity with Botulinum toxin 21 .…”

Section: Procedurementioning

confidence: 99%

Conceptualization and Development of the Leg Activity Measure (LegA) for Patient and Carer Reported Assessment of Activity in the Paretic Leg

Ashford

Jackson

Mahaffey

et al. 2016

Physiotherapy Res Intl

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ObjectiveTo develop a patient reported outcome measure (PROM) of active and passive function in the paretic lower limb. MethodsPotential items for inclusion were identified through a) systematic review and analysis of existing measures and b) analysis of the primary goals for treatment in a spasticity service. Item reduction was achieved through consultation with a purposively-selected group of experienced physiotherapists and occupational therapists (n=16) in a 2-round Delphi process. This was followed by review of Delphi consultation findings by the Project Advisory Group (PAG) consisting of patients and carers. Results Development of the LegA included two rounds of Delphi consultation. Further roundswere not required due to the high degree (80%) of agreement between respondents in rounds one and two. From an initial shortlist of 126 items, 29 items were initially identified for inclusion in LegA, and subsequently refined to a 24-item (two sub-scales) tool consisting of 9 passive function sub-scale items and 15 active function sub-scale items. The Delphi consultation ensured content validity, due to the experience of the clinicians in this area of practice and therefore appropriate reduction of items. In common with previous work in the upper limb, a 5-point ordinal scaling structure was chosen, with ratings based on activity over the preceding 7 days. ConclusionsThe LegA is designed to measure passive and active function following focal interventions for the paretic lower limb. Content and face validity have initially been Development of the Leg Activity Measure (LegA) 3 addressed within the development process. The next phase of development will involve formal evaluation of psychometric properties. Word count 250

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Botulinum toxin A for treatment of upper limb spasticity following stroke: A multi-centre randomized placebo-controlled study of the effects on quality of life and other person-centred outcomes

Abstract: Although no change in quality of life was demonstrated using the AQoL, botulinum toxin type A was found to be safe and efficacious in reducing upper limb spasticity and improving the ability to achieve personal goals.

Cited by 151 publications

References 24 publications

BoTULS: a multicentre randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

BoTULS: a multicentre randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

Botulinum toxin type A combined with neurodynamic mobilization for lower limb spasticity: a case report

Conceptualization and Development of the Leg Activity Measure (LegA) for Patient and Carer Reported Assessment of Activity in the Paretic Leg

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