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Botulinum toxin as early intervention for spasticity after stroke or non-progressive brain lesion: A meta-analysis.

Author

Raymond L. Rosales,
Fran Efendy,
Ericka  S. Teleg,
Mary  M. Delos Santos,
Mary  C. Rosales,
Marc Ostrea,
Michelle  J. Tanglao,
Arelene R. Ng

Related Institution

Department of Neurology and Psychiatry - University of Santo Tomas Hospital

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Publication Information

Publication Type
Journal
Title
Journal of the Neurological Sciences
Publication Date
October 2016
Volume
371
Page(s)
6-14

Abstract

Spasticity is a functionally limiting disorder that commonly occurs following stroke or severe brain injury, and may lead to disability and pain. In tandem with neurorehabilitation, botulinum toxin type A (BoNT-A) is the recommended first-line treatment for spasticity and, to date, the majority of trials have reported BoNT-A use in patients N6 months after ictus. The present meta-analysis aimed to evaluate the effects of early BoNT-A injection for post-stroke spasticity on improvements in hypertonicity, disability, function and associated pain. A literature search yielded six studies reporting the effects of BoNT-A treatment within 3 months post-stroke; three in the upper limb and three in the lower limb. All six studies permitted concomitant rehabilitation. Reduction in hypertonicity was compared in all six studies and revealed a significant treatment effect (P = 0.0002) on the most affected joints between weeks 4 and 12 following injection. However, no significant effects of treatment were observed for improvement in disability at week 4 or improvement in function at weeks 4 and 20-24. A trend towards reduction in spasticity-related pain at week 4 following BoNT-A treatment (P = 0.13) was also observed. These results demonstrate the beneficial effects of BoNT-A treatment on improving hypertonicity within 3 months post-stroke and emphasize the importance of concomitant neurorehabilitation therapy.

Physical Location

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Philippine Council for Health Research and Development Library Fulltext pdf (Request Document)

 
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