Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity

Demetrios, Marina; Turner‐Stokes, Lynne; Brand, Caroline; McSweeney, Shane; Khan, Fary

doi:10.1002/14651858.cd009689

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…9 The importance of initiating a prompt, intense rehabilitation program in the first 3 months cannot be overemphasized. 11 The overall MAS showed significant improvement in our study, with a median of difference of −1 and −2 at 1-month and 2-months post-injection, respectively. Significant improvement in MAS and the R1 component of the MTS was also found in several muscle groups.…”

Section: Discussionsupporting

confidence: 48%

“…First of all, our multidisciplinary team of physiotherapists, occupational therapists and prosthetic orthotists provided a high-quality rehabilitation program for the patients after Botox injection; this had been shown in previous studies to be of critical importance. 11,20,21 Secondly, the goal-setting process, as an essential part of the management program, helped patients to set goals that are highly individualized and personally relevant. It promoted patient's engagement with the intervention as a collaborative process with the multidisciplinary team.…”

Section: Discussionmentioning

confidence: 99%

“…Although the primary nerve terminal would recover in about 90 days, the treatment provides a window of opportunity for intense rehabilitation and other interventions mentioned above. 9,11 While its efficacy has already been reported by other rehabilitation centres, local data are lacking. Here, we present our experience with BTX injection provided under a multidisciplinary spasticity management programme at the authors' institution over a period of 2.5 years.…”

Section: Introductionmentioning

confidence: 99%

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Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity

et al. 2016

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Aim: Spasticity gives rise to impairment in motor functions and activities of daily living. Botulinum toxin (BTX) can be injected to temporarily paralyze the affected muscles, which provides a window of opportunity for rehabilitation. We present our 2.5-year experience with BTX injection and a patient-specific rehabilitation program provided by a multidisciplinary team, which consists of neurosurgeons, nurses, physiotherapists, occupational therapists and prosthetic orthotists. Patients and Methods: This is a retrospective study of prospectively collected data in a local hospital including 22 patients suffering from spasticity. Outcome measures include goal attainment, caregiver burden and biomechanical assessment by Modified Ashworth Scale and Modified Tardieu Scale (MTS). Results: OnabotulinumtoxinA injection together with rehabilitation facilitates the attainment of patientcentred physical goals in daily activities. It reduces caregiver burden. Spasticity is reduced particularly for finger and wrist flexors as well as hip adductors. Responses of ankle plantarflexors are less satisfactory which may be due to inadequate dosages. Initial improvement in the R2 component of the MTS for ankle plantarflexors and hip adductors may be attributable to the application of ankle-foot orthosis and abduction pillow. Conclusions: Multidisciplinary management for spasticity is feasible within our healthcare setting and our promising findings indicate its wider adoption in this locality.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity

et al. 2016

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“…Many non-pharmacological and pharmacological interventions are used to manage spasticity in clinical settings 11 12 13 14 . The non-pharmacological interventions include stretching, passive movements, transcutaneous electric nerve stimulation (TENS), shock wave, whole-body vibration, focal muscle vibration, mental practice, task-oriented, functional electrical stimulation cycling, electromyography biofeedback, , therapeutic ultrasound, acupuncture, and orthotics 9 15 16 17 18 19 20 21 . The pharmacologic agents have many disadvantages, such as high cost, serious adverse effects, and a lack of efficacy over time.…”

Section: Introductionmentioning

confidence: 99%

Effects of Repetitive Transcranial Magnetic Stimulation on Upper Extremity Spasticity Post-Stroke: A Systematic Review

Alashram

Padua²,

Romagnoli³

et al. 2021

Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin

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Upper extremity spasticity is one of the most popular impairments following stroke. It can reduce patients' functional level. Recently, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising tool in stroke rehabilitation. This review was conducted to investigate the immediate and long-term effects of rTMS on the upper extremity spasticity post-stroke and determine the optimal treatment protocols. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases were searched for randomized controlled trials investigating the effect of rTMS on the upper extremity spasticity in patients with stroke. The methodological quality was assessed using the Cochrane Collaboration’s tool. Ten randomized clinical trials were met the inclusion criteria. A total of 225 patients were included in this analysis, 35.30% of whom were females. The mean age for all patients was 60.14 years. The findings showed heterogeneous evidence on the benefits of rTMS intervention in the upper extremity spasticity post-stroke. The evidence for the effect of rTMS on the upper extremity spasticity post-stroke is promising. Combining rTMS with other rehabilitation interventions may show a superior effect in reducing the upper extremity spasticity compared with rTMS intervention alone. Further randomized controlled trials with long-term follow-ups are warranted.

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“…No entanto, a elaboração do plano terapêutico deve ser claramente estabelecida antes da terapia com a toxina, pois a melhora funcional é mais empírica naqueles pacientes com força muscular residual e função da mão, por isso, o tratamento deve ser individualizado em todos os casos (Slawek et al, 2005). Desse modo, a prática clínica para essa terapia deve ser baseada em um nível de julgamento profissional, por meio de estudos clínicos e experiencia empírica dos profissionais, e mais ensaios são necessários para facilitar a prática médica baseada em evidência (Demetrios et al, 2013)…”

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Tratamento de sequelas do Acidente Vascular Encefálico (AVE) com toxina botulínica: Uma revisão de literatura

Figueiredo

Neto

Nogueira

et al. 2021

RSD

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Introdução: O acidente vascular encefálico (AVE) é um evento bastante prevalente na população mundial, e dentre suas sequelas, destaca-se a espasticidade muscular e paralisias. A toxina botulínica é uma técnica farmacológica que traz efeitos benéficos ao paciente com espasticidade, como o ganho de amplitude de movimento e melhora da função dos membros afetados. Objetivo: identificar as evidências acerca do uso dessa toxina a esses pacientes, principalmente perante a espasticidade muscular, evento fortemente relacionado após AVE. Metodologia: Trata-se de uma pesquisa descritiva do tipo revisão integrativa da literatura, que busca evidências sobre o uso da toxina botulínica para tratamento de sequelas do AVE. A pesquisa foi realizada por meio de bases de dados PubMed, MEDLINE, Scielo, CDSR, Google Scholar, BVS e EBSCO, no período de 2003 a 2021. Dessa maneira, totalizaram-se 26 produções científicas para a revisão integrativa da literatura. Resultados: o tratamento da espasticidade com a toxina botulínica tem maior êxito quando a administração segue alguns critérios como: o ajuste da dose de acordo com a idade, com o peso, grau de espasticidade e musculatura administrada. Conclusão: a aplicação dessa toxina, aliado à fisioterapia continuada, é o tratamento de primeira escolha para a espasticidade muscular, particularmente em pacientes que apresentam sequelas pós acidente vascular cerebral, com o intuito de aumentar a mobilidade, amplitude de movimento, facilitar a realização da higiene e de outras atividades funcionais, melhorar o desgaste da imobilização e a dor, e, dessa maneira, promover a melhoria da qualidade de vida desses pacientes.

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Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity

Cited by 5 publications

References 33 publications

Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity

Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity

Effects of Repetitive Transcranial Magnetic Stimulation on Upper Extremity Spasticity Post-Stroke: A Systematic Review

Tratamento de sequelas do Acidente Vascular Encefálico (AVE) com toxina botulínica: Uma revisão de literatura

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