Effect of treatment with botulinum toxin on spasticity

Das, Tanmoy; Park, D. M.

doi:10.1136/pgmj.65.762.208

Cited by 106 publications

(46 citation statements)

References 7 publications

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“…6,15,16 Treatment was effective and safe at doses of 500, 1000, and 1500 U. The optimal dose of Dysport for the treatment of patients with residual voluntary movement in the upper limb appears to be 1000 U.…”

Section: Discussionmentioning

confidence: 98%

A Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Study to Compare the Efficacy and Safety of Three Doses of Botulinum Toxin Type A (Dysport) With Placebo in Upper Limb Spasticity After Stroke

Bakheit

Thilmann

Ward

et al. 2000

Stroke

276

191

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Background and Purpose —We sought to define an effective and safe dose of botulinum toxin type A (Dysport) for the treatment of upper limb muscle spasticity due to stroke. Methods —This was a prospective, randomized, double-blind, placebo-controlled, dose-ranging study. Patients received either a placebo or 1 of 3 doses of Dysport (500, 1000, 1500 U) into 5 muscles of the affected arm. Efficacy was assessed periodically by the Modified Ashworth Scale and a battery of functional outcome measures. Results —Eighty-three patients were recruited, and 82 completed the study. The 4 study groups were comparable at baseline with respect to their demographic characteristics and severity of spasticity. All doses of Dysport studied showed a significant reduction from baseline of muscle tone compared with placebo. However, the effect on functional disability was not statistically significant and was best at a dose of 1000 U. There were no statistically significant differences between the groups in the incidence of adverse events. Conclusions —The present study suggests that treatment with Dysport reduces muscle tone in patients with poststroke upper limb spasticity. Treatment was effective at doses of Dysport of 500, 1000, and 1500 U. The optimal dose for treatment of patients with residual voluntary movements in the upper limb appears to be 1000 U. Dysport is safe in the doses used in this study.

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Section: Discussionmentioning

confidence: 98%

A Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Study to Compare the Efficacy and Safety of Three Doses of Botulinum Toxin Type A (Dysport) With Placebo in Upper Limb Spasticity After Stroke

Bakheit

Thilmann

Ward

et al. 2000

Stroke

276

191

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“…The first studies of the application of BTX-A in the treatment of stroke were published in 1989 by Das and Park (15,16). Although oral medications including baclofen, dantrolen, tizanidine, and diazepam have some effects on spasticity, BTX-A has proven to be more effective.…”

Section: Discussionmentioning

confidence: 99%

“…In some randomized and controlled studies, BTX-A was injected into upper extremities and improvement was achieved in functionality and spasticity but not in pain compared with placebo (16,17,18). Studies in which BTX-A was injected into lower extremities, a significant improvement was achieved in spasticity.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of Botulinum Toxin Injection Effect for Poststroke Spasticity Treatment

Demiryürek¹,

Gündoğdu²

2017

tnd

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Amaç: Bu çalışmada, inme sonrası üst ya da alt ekstremite spastisitesi gelişen hastaların tedavisinde Botulinum toksin-tip A (BTX-A) enjeksiyonunun spastisite ve spastisiteye bağlı ağrı tedavisindeki etkinliği ile günlük yaşam aktivitelerine olan etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem:Bu çalışmaya inme sonrası üst ekstremite ya da alt ekstremitede spastisite nedenli 249±41 U BTX-A uygulanmış 35 (23 sağ taraf, 12 sol taraf) hasta alındı. Üst ekstremitede dirsek, el bileği ve parmaklarda, alt ekstremitede ise bacak, diz ve ayak bileğinde spastisite derecesi; BTX-A enjeksiyonu öncesi, işlem sonrası 1. ay ve işlem sonrası 3. ay Modifiye Ashworth Skalası (MAS) ile değerlendirildi. Ayrıca BTX-A işlemi öncesi, işlem sonrası 1. ay ve işlem sonrası 3. ay günlük yaşam aktiviteleri Barthel indeksi ile, spastisiteye bağlı ağrı ise Vizüel Analog Skalası (VAS) ile değerlendirildi. Bulgular: Çalışmaya alınan hastaların yaş ortalaması 60±6 idi. Hastaların %69'unda üst ve alt ekstremite, %31'inde ise üst ya da alt ekstremite etkilenmişti. MAS, VAS ve Barthel indeksi kullanılarak BTX-A'nın tedavi öncesine göre anlamlı olarak spastisite ve ağrı şiddetinde azalma, fonksiyonellikte ve yaşam kalitesinde ise artma sağladığı sonucuna varıldı. Birinci ayda sağlanan faydanın 3. ay takiplerinde de sürdüğü saptandı.Sonuç: İnmeye bağlı spastisite tedavisinde BTX-A uygulanması yan etki açısından güvenli, hastaların ağrısını azaltan, fonksiyonelliği ve yaşam kalitesini artıran, uzun süreli etkinlik sağlayabilen bir yöntemdir.Anahtar Kelimeler: İnme, spastisite, botulinum toksin, ağrıObjective: In this study we aimed to evaluate the effectivity of treatment with the botulinum toxin-type A (BTX-A) on spasticity, spasticity-related pain, and the daily living activities in post-stroke patients with upper or lower limb spasticity. Materials and Methods:A total of 35 (23 right side, 12 left side) post-stroke patients who had upper and/or lower limb spasticity were enrolled to the study. BTX-A (249±41 U) was applied to their affected extremities. The degree of spasticity in the upper (elbow, wrists, and fingers) and lower (leg, knee and ankle) extremities was evaluated before treatment, 1 month, and 3 months after treatment using Modified Ashworth Scale (MAS). Daily life activities and severity of spasticity-related pain were also evaluated using the Barthel index and Visual Analogue Scale (VAS) at the same time points. Results:The average age of the patients in the study was 60±6 years. Both upper and lower extremities were affected in 69%, whereas upper or lower extremities were affected in 31% of patients. BTX-A provided improvement in severity of the spasticity, pain scale, functionality, and quality of life according to the MAS, VAS, and Barthel indexes.The benefits were sustained in the first 3 months of the post-treatment.Conclusion: BTX-A in the treatment of post-stroke spasticity is a reliable method in terms of adverse effects, pain reduction, its ability to provide long-term effectiveness, and increase functionality an...

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“…BoNT-A is effective for spasticity reduction [1][2][3], even if a reduction or absence of response of therapeutic effect can occur [8]. A condition of transient nonresponse was identified, in which the first application of BoNT-A could be not efficacious, but subsequent injections may produce the desired clinical effects.…”

Section: Therapeutic Response and Adverse Effects Of Bont-a For Treatmentioning

confidence: 99%

“…Since 1989, the effectiveness of BoNT-A in reducing poststroke spasticity showed reversibility and low prevalence of complications [1], obtaining the approval of U.S. Food and Drug Administration for upper limb spasticity after stroke in 2010. In the following years, many studies have been published demonstrating its safety and effectiveness [2,3].…”

Section: Introductionmentioning

confidence: 99%

High doses of incobotulinumtoxinA for the treatment of post-stroke spasticity: are they safe and effective?

Santamato

Ranieri

Solfrizzi

et al. 2016

Expert Opinion on Drug Metabolism & Toxicology

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Effect of treatment with botulinum toxin on spasticity

Cited by 106 publications

References 7 publications

A Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Study to Compare the Efficacy and Safety of Three Doses of Botulinum Toxin Type A (Dysport) With Placebo in Upper Limb Spasticity After Stroke

A Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Study to Compare the Efficacy and Safety of Three Doses of Botulinum Toxin Type A (Dysport) With Placebo in Upper Limb Spasticity After Stroke

The Evaluation of Botulinum Toxin Injection Effect for Poststroke Spasticity Treatment

High doses of incobotulinumtoxinA for the treatment of post-stroke spasticity: are they safe and effective?

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