Effectiveness of Botulinum Toxin Treatment for Upper Limb Spasticity Poststroke Over Different ICF Domains: A Systematic Review and Meta-Analysis.

Archives of Physical Medicine and Rehabilitation
Aukje AndringaGert Kwakkel

Abstract

To provide a comprehensive overview of reported effects and scientific robustness of botulinum toxin (BoNT) treatment regarding the main clinical goals related to poststroke upper limb spasticity, using the International Classification of Functioning, Disability and Health. Embase, PubMed, Wiley/Cochrane Library, and Ebsco/CINAHL were searched from inception up to May 16, 2018. We included randomized controlled trials comparing upper limb BoNT injections with a control intervention in patients with a history of stroke. A total of 1212 unique records were screened by 2 independent reviewers. Forty trials were identified, including 2718 patients with history of stroke. Outcome data were pooled according to assessment timing (ie, 4-8wk and 12wk after injection), and categorized into 6 main clinical goals (ie, spasticity-related pain, involuntary movements, passive joint motion, care ability, arm and hand use, and standing and walking performance). Sensitivity analyses were performed for the influence of study and intervention characteristics, involvement of pharmaceutical industry, and publication bias. Robust evidence is shown for the effectiveness of BoNT in reducing resistance to passive movement, as measured with the (Modified...Continue Reading

Citations

Nov 14, 2019·Current Neurology and Neuroscience Reports·Alyson R PlecashThalia S Field
Nov 22, 2019·Neurorehabilitation and Neural Repair·Amanda Claire WallaceDavid J Werring
Jan 4, 2020·Journal of Neural Engineering·Yang LiuYingchun Zhang
Jun 9, 2020·Neurorehabilitation and Neural Repair·Aukje AndringaGert Kwakkel
Dec 6, 2019·The Journal of International Medical Research·Zichong LuoLe Li
Jul 1, 2020·Developmental Medicine and Child Neurology·Carel Gm Meskers, Gert Kwakkel
Aug 12, 2020·Journal of Neuroengineering and Rehabilitation·Susanne PalmcrantzJörgen Borg
Oct 20, 2020·Pain Management·Ke-Vin ChangLevent Özçakar
Dec 15, 2020·Journal of Neurologic Physical Therapy : JNPT·Patricia L ScheetsTimothy Nordahl
Apr 8, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Teresa PaolucciRaoul Saggini
Apr 4, 2021·PM & R : the Journal of Injury, Function, and Rehabilitation·Aukje AndringaCarel Meskers

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