Can Botulinum Toxin Decrease Carer Burden in Long Term Care Residents With Upper Limb Spasticity? A Randomized Controlled Study

Lam, Kuen; Lau, Kwok Kwong; So, Kar Kui; Tam, Cheuk Kwan; Wu, Yee Ming; Cheung, Gloria; Liang, Ka Shing; Yeung, Kwan Mo; Lam, Kin Yip; Yui, S.; Leung, Christine

doi:10.1016/j.jamda.2012.03.005

Cited by 39 publications

(49 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar finding were observed in studies in which pre-specified activities or disability domains as the principal therapeutic target were identified and discussed with patients and caregivers [11,13,41,45,47,49]. A recent RCT by Lam et al showed significant GAS and CBS score increase at 6 weeks in chronic UL spastic patients treated with 1000 MU of BTX-A (Dysport) compared to placebo group [54]. Likewise, a previous meta-analysis concerning the efficacy and safety of BTX-A toxin (Botox or Dysport) showed significant improvement of GAS score at 4-6 weeks after injecting BTX-A (odds ratio= 5.85, 95% CI=3.12-10.95) [10].…”

Section: Discussionsupporting

confidence: 67%

Does Spasticity Reduction by Botulinum Toxin Type A Improve Upper Limb Functionality in Adult Post-Stroke Patients? A Systematic Review of Relevant Studies

Simone¹

2013

J Neurol Neurophysiol

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 67%

Does Spasticity Reduction by Botulinum Toxin Type A Improve Upper Limb Functionality in Adult Post-Stroke Patients? A Systematic Review of Relevant Studies

Simone¹

2013

J Neurol Neurophysiol

View full text Add to dashboard Cite

“…A fifth Class I study 34 of patients with upper limb spasticity focused on caregiver burden. This study found that 67% of caregivers of patients receiving aboBoNT-A reported a $4-point reduction on the carer burden scale as compared with 20% of caregivers of patients injected with saline (p 5 0.001).…”

Section: Spasticity In Adultsmentioning

confidence: 99%

Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache

et al. 2016

View full text Add to dashboard Cite

Objective: To update the 2008 American Academy of Neurology (AAN) guidelines regarding botulinum neurotoxin for blepharospasm, cervical dystonia (CD), headache, and adult spasticity. Methods:We searched the literature for relevant articles and classified them using 2004 AAN criteria.Results and recommendations: Blepharospasm: OnabotulinumtoxinA (onaBoNT-A) and incobotulinumtoxinA (incoBoNT-A) are probably effective and should be considered (Level B). AbobotulinumtoxinA (aboBoNT-A) is possibly effective and may be considered (Level C). CD: AboBoNT-A and rimabotulinumtoxinB (rimaBoNT-B) are established as effective and should be offered (Level A), and onaBoNT-A and incoBoNT-A are probably effective and should be considered (Level B). Adult spasticity: AboBoNT-A, incoBoNT-A, and onaBoNT-A are established as effective and should be offered (Level A), and rimaBoNT-B is probably effective and should be considered (Level B), for upper limb spasticity. AboBoNT-A and onaBoNT-A are established as effective and should be offered (Level A) for lower-limb spasticity. Headache: OnaBoNT-A is established as effective and should be offered to increase headache-free days (Level A) and is probably effective and should be considered to improve health-related quality of life (Level B) in chronic migraine. OnaBoNT-A is established as ineffective and should not be offered for episodic migraine (Level A) and is probably ineffective for chronic tension-type headaches (Level B). Neurology ® 2016;86:1818-1826 GLOSSARY AAN 5 American Academy of Neurology; aboBoNT-A 5 abobotulinumtoxinA; AE 5 adverse event; BDI 5 Blepharospasm Disability Index; BoNT 5 botulinum neurotoxin; CD 5 cervical dystonia; CI 5 confidence interval; CM 5 chronic migraine; DAS 5 Disability Assessment Scale; EM 5 episodic migraine; incoBoNT-A 5 incobotulinumtoxinA; onaBoNT-A 5 onabotulinumtoxinA; QOL 5 quality of life; RD 5 risk difference; rimaBoNT-B 5 rimabotulinumtoxinB; RMT 5 randomized, masked trials; TWSTRS 5 Toronto Western Spasmodic Torticollis Rating Scale; TZD 5 tizanidine.

show abstract

“…Long-term care patients are often inadequately served as a consequence of limited resources (Lam et al, 2012). Spasticity can lead to chronic disability with a negative impact on the quality of life of patients and caregivers (Zorowitz et al, 2013;Gillard et al, 2015).…”

Section: Burden Of Post-stroke Spasticity: Impact Of Treatmentmentioning

confidence: 99%

“…Spasticity can lead to chronic disability with a negative impact on the quality of life of patients and caregivers (Zorowitz et al, 2013;Gillard et al, 2015). Botulinum toxin has been found to significantly decrease carer burden in long-term care stroke patients with spasticity, mainly owing to its effects in terms of reducing limb spasticity and improving the joint range of movement of the affected limbs (Lam et al, 2012). Usual (rehabilitation) care combined with onabotulinumtoxinA has been found to allow cost-effective improvement of disability due to post-stroke spasticity (taking into account the reduction of the total, society-wide cost of managing patients, including the impact of caregiver burden) (Doan et al, 2013).…”

Section: Burden Of Post-stroke Spasticity: Impact Of Treatmentmentioning

confidence: 99%

Management of spasticity with onabotulinumtoxinA: practical guidance based on the italian real-life post-stroke spasticity survey

Sandrini

Baricich

Cisari

et al. 2018

Functional Neurology

View full text Add to dashboard Cite

SummaryThe 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 PostStroke Spasticity Survey. Stroke patients should be referred to spasticity services that have adequate facilities and multidisciplinary teams with the necessary training, competence and expertise. The current literature shows a strong correlation between the development of post-stroke spasticity and the degree of central sensorimotor system destruction/disorganization. Use of tools such as the Poststroke Checklist may help clinicians in the long-term follow-up of stroke patients. The maximum dose of onabotulinumtoxinA -according to the current literature this ranges from 300U to 400U for upper limb and from 500U to 600U for lower limb aggregate postures -should be re-considered. In addition, there is a need for future consensus (also based on pharmacoeconomic considerations) on consistent clinical care models for the management of patients with post-stroke spasticity.

show abstract

Can Botulinum Toxin Decrease Carer Burden in Long Term Care Residents With Upper Limb Spasticity? A Randomized Controlled Study

Cited by 39 publications

References 21 publications

Does Spasticity Reduction by Botulinum Toxin Type A Improve Upper Limb Functionality in Adult Post-Stroke Patients? A Systematic Review of Relevant Studies

Does Spasticity Reduction by Botulinum Toxin Type A Improve Upper Limb Functionality in Adult Post-Stroke Patients? A Systematic Review of Relevant Studies

Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache

Management of spasticity with onabotulinumtoxinA: practical guidance based on the italian real-life post-stroke spasticity survey

Contact Info

Product

Resources

About