Dystonia, Spasticity and Botulinum Toxin Therapy: Rationale, Evidences and Clinical Context

Rosales, Raymond L.

doi:10.5772/27435

Cited by 2 publications

(2 citation statements)

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“…64 Early single-dose BoNT-A treatment (<3 months after stroke) of spasticity has been investigated in three upper limb studies (summarised in Figure 2). [65][66][67][68] In the first study, a small cohort of patients with no arm function was found to benefit functionally. 65 In the second study, development of disabling finger flexion was significantly reduced compared with placebo.…”

Section: Physical Therapymentioning

confidence: 99%

“…The role of BoNT-A therapy in early intervention afterIncorporates information from Cousins et al, Hesse et al and Rosales et al[65][66][67] and is adapted with permission from Rosales et al68 BoNT-A = botulinum toxin A; DAS = Disability Assessment Scale; EMG = Electromyography; GIC = Global Impression of Change; MAS = Modified Ashworth Scale; QoL = Quality of life Special Report Spastic Paresis met, they may enter a period of mourning or despair and/or develop a loss of self-worth and feelings of isolation. 79 Patients then either reject the need for further help or develop a more positive attitude of determination to beat the new obstacle facing them.…”

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confidence: 99%

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How Can We Improve Current Practice in Spastic Paresis?

Fheodoroff¹,

Jacinto²,

Geurts³

et al. 2016

European Neurological Review

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Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity. The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients℉ quality of life, by affecting their ability to perform normal activities. This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services. The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients℉ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.

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