How effective is physical therapy for gait muscle activity in hemiparetic patients who receive botulinum toxin injections?

Fujita, Kazuki; Miaki, Hiroichi; Hori, Hideaki; Kobayashi, Yasutaka; Nakagawa, Takao

doi:10.23736/s1973-9087.18.05168-7

Cited by 21 publications

(28 citation statements)

References 33 publications

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“…Tao et al (2015) reported that there was a significant difference in step length, cadence, and speed at eight weeks, as well as the FMA and 6MWT compared to the control group (placebo injection) [24]. Fujita et al (2019) reported that, as compared with the control group (BoNT-A only), walking speed and cadence were significantly increased and the rate of change was significantly greater [36]. In addition, in the intervention group, the step length increased significantly, and an improvement of the asymmetry index of step length was observed.…”

Section: Effect Of Bont-a and Rehabilitation Of Motor Functionmentioning

confidence: 99%

“…In allocation concealment, 38.4% of the studies were appropriate. In regard to the blinding of participants and personnel, some non-RCT studies were marked high risk [18,25,36]. In addition, in the case where the control group was not placebo injection, it was considered difficult to blind the subjects because the intervention content differed between the intervention group and the control group.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Total sessions varied from study to study and ranged from five to 120 sessions. There were three studies that used ES or functional electrical stimulation (FES) as adjuvant treatment, three studies that used a robot, two studies that did taping and casting, and one study that used constraint-induced movement therapy (CIMT) [36][37][38][39][40][41][42][43][44][45].…”

Section: Rehabilitationmentioning

confidence: 99%

“…First, the intervention group had improved spasticity in 23 of 24 studies, except for two studies that did not evaluate spasticity. However, there was no significant difference in improvement in spasticity when compared to the group in which the control group was BoNT-A alone [21,22,36,41]. Moreover, in the studies compared with the group where the control group was placebo injection, three of seven studies were compared among the groups and were considered to have a significant difference [24,27,34].…”

Section: Effect Of Bont-a and Rehabilitation Of Motor Functionmentioning

confidence: 99%

“…Regarding motor function related to the upper extremity, seven of 14 studies that administered BoNT-A to the lower extremity indicated that significant improvement in motor function was observed compared to the control group [22][23][24]36,39,41,43]. Tao et al (2015) reported that there was a significant difference in step length, cadence, and speed at eight weeks, as well as the FMA and 6MWT compared to the control group (placebo injection) [24].…”

Section: Effect Of Bont-a and Rehabilitation Of Motor Functionmentioning

confidence: 99%

See 4 more Smart Citations

Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function

Hara

Momosaki

Niimi

et al. 2019

Toxins

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Aim: The purpose of this study was to examine the effectiveness of botulinum toxin A (BoNT-A) therapy combined with rehabilitation on motor function in post-stroke patients. Methods: The following sources up to December 31, 2018, were searched from inception for articles in English: Pubmed, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL. Trials using injections of BoNT-A for upper and lower limb rehabilitation were examined. We excluded studies that were not performed for rehabilitation or were not evaluated for motor function. Results: Twenty-six studies were included. In addition to rehabilitation, nine studies used adjuvant treatment to improve spasticity or improve motor function. In the upper limbs, two of 14 articles indicated that significant improvement in upper limb motor function was observed compared to the control group. In the lower limbs, seven of 14 articles indicated that significant improvement in lower limb motor function was observed compared to the control group. Conclusions: The effect of combined with rehabilitation is limited after stroke, and there is not sufficient evidence, but results suggest that BoNT-A may help to improve motor function. In future studies, the establishment of optimal rehabilitation and evaluation times of BoNT-A treatment will be necessary for improving motor function and spasticity.

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Section: Effect Of Bont-a and Rehabilitation Of Motor Functionmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Rehabilitationmentioning

confidence: 99%

Section: Effect Of Bont-a and Rehabilitation Of Motor Functionmentioning

confidence: 99%

Section: Effect Of Bont-a and Rehabilitation Of Motor Functionmentioning

confidence: 99%

See 3 more Smart Citations

Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function

Hara

Momosaki

Niimi

et al. 2019

Toxins

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Intramuscular injections of botulinum toxin for the treatment of upper back myofascial pain syndrome: A systematic review of randomized controlled trials

Leonardi,

Alito,

Portaro

et al. 2023

European Journal of Pain

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Background and ObjectiveMyofascial pain syndrome (MPS) is a chronic musculoskeletal disorder characterized by the presence of trigger points. Among the treatment options, botulinum toxin injections have been investigated. The aim of this paper was to provide a synthesis of the evidence on intramuscular botulinum toxin injections for upper back MPS.Databases and Data TreatmentA systematic review of the literature was performed on the PubMed, Scopus and Cochrane Library, using the following formula: (“botulinum”) AND (“musculoskeletal”) AND (“upper back pain”) OR (“myofascial pain”).ResultsTen studies involving 651 patients were included. Patients in the control groups received placebo (saline solution) injections, anaesthetic injections + dry needling or anaesthetic injections. The analysis of the trials revealed modest methodological quality: one “Good quality” study, one “Fair” and the other “Poor”. No major complications or serious adverse events were reported. Results provided conflicting evidence and did not demonstrate the superiority of botulinum toxin over comparators. Most of the included trials were characterized by a small sample size, weak power analysis, different clinical scores used and non‐comparable follow‐up periods. Even if there is no conclusive evidence, the favourable safety profile and the positive results of some secondary endpoints suggest a potentially beneficial action in pain control and quality of life.ConclusionThe currently available studies show conflicting results. Their overall low methodological quality does not allow for solid evidence of superiority over other comparison treatments. Further insights are needed to properly profile patients who could benefit more from this peculiar injective approach.SignificanceThe randomized controlled trials included in this review compared using botulinum toxin to treat upper back MPS with placebo or active treatments (e.g., dry needling or anaesthetics) showing mixed results overall. Despite the lack of clear evidence of superiority, our study suggests that the use of botulinum toxin should not be discouraged. Its safety profile and encouraging results in pain control, motor recovery and disability reduction make it an interesting treatment, particularly in the subset of patients with moderate to severe chronic pain and active trigger points. To support the safety and efficacy of botulinum toxin, further high‐quality studies are needed.

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Beyond speed: Gait changes after botulinum toxin injections in chronic stroke survivors (a systematic review)

2019

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How effective is physical therapy for gait muscle activity in hemiparetic patients who receive botulinum toxin injections?

Cited by 21 publications

References 33 publications

Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function

Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function

Intramuscular injections of botulinum toxin for the treatment of upper back myofascial pain syndrome: A systematic review of randomized controlled trials

Beyond speed: Gait changes after botulinum toxin injections in chronic stroke survivors (a systematic review)

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