Botulinum neurotoxins for post‐stroke spasticity in adults: A systematic review
Identifieur interne : 002426 ( Main/Exploration ); précédent : 002425; suivant : 002427Botulinum neurotoxins for post‐stroke spasticity in adults: A systematic review
Auteurs : Antonio Emanuele Elia [Italie] ; Graziella Filippini [Italie] ; Daniela Calandrella [Italie] ; Alberto Albanese [Italie]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-04-30.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Anti-Dyskinesia Agents, Botulinum Toxins.
- complications : Stroke.
- drug therapy : Muscle Spasticity.
- etiology : Muscle Spasticity.
- Humans.
Abstract
The aim of this systematic review was to determine whether botulinum neurotoxin (BoNT) reduce spasticity or improve function in adult patients after stroke. Eleven double‐blind randomized placebo‐controlled trials met inclusion criteria. They encompassed 782 patients, 767 (98%) of whom received BoNT/A, and 15 (2%) BoNT/B. Most studies used the Ashworth scale as primary outcome measure. Differences between treated and control groups were assessed as categorical or continuous comparisons. The overall effect on upper limb spasticity was in favor of BoNT/A. A significantly higher number of patients had a reduction of upper limb spasticity at 4‐week and 8‐week evaluations in the treatment group compared with placebo. Mean changes in joint spasticity revealed improvement 3 to 6 weeks and 9 to 12 weeks after treatment. There were insufficient data to establish BoNT/A efficacy on lower limb spasticity or the effect of BoNT/B on the upper and lower limbs. Because of inconsistency and heterogeneity of the available data, it was not possible to perform a meta‐analysis on disability and patients' reported outcomes. There was an overlapping safety profile between the treatment and the placebo groups. BoNT/A reduces upper limb spasticity in patients post‐stroke, but the improvement in functional ability remains to be established. This gap needs to be filled by new studies to assess the effect of BoNT in the context of multidisciplinary patient management. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22452
Affiliations:
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-04-30">2009-04-30</date><biblScope unit="vol">24</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="801">801</biblScope><biblScope unit="page" to="812">812</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">131A1CBB2C6AF3B98982AF63BF7C3EC08CAD74FF</idno><idno type="DOI">10.1002/mds.22452</idno><idno type="ArticleID">MDS22452</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-Dyskinesia Agents (therapeutic use)</term><term>Botulinum Toxins (therapeutic use)</term><term>Humans</term><term>Muscle Spasticity (drug therapy)</term><term>Muscle Spasticity (etiology)</term><term>Stroke (complications)</term><term>botulinum toxin</term><term>meta‐ analysis</term><term>spasticity</term><term>stroke</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Dyskinesia Agents</term><term>Botulinum Toxins</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Muscle Spasticity</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Muscle Spasticity</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this systematic review was to determine whether botulinum neurotoxin (BoNT) reduce spasticity or improve function in adult patients after stroke. Eleven double‐blind randomized placebo‐controlled trials met inclusion criteria. They encompassed 782 patients, 767 (98%) of whom received BoNT/A, and 15 (2%) BoNT/B. Most studies used the Ashworth scale as primary outcome measure. Differences between treated and control groups were assessed as categorical or continuous comparisons. The overall effect on upper limb spasticity was in favor of BoNT/A. A significantly higher number of patients had a reduction of upper limb spasticity at 4‐week and 8‐week evaluations in the treatment group compared with placebo. Mean changes in joint spasticity revealed improvement 3 to 6 weeks and 9 to 12 weeks after treatment. There were insufficient data to establish BoNT/A efficacy on lower limb spasticity or the effect of BoNT/B on the upper and lower limbs. Because of inconsistency and heterogeneity of the available data, it was not possible to perform a meta‐analysis on disability and patients' reported outcomes. There was an overlapping safety profile between the treatment and the placebo groups. BoNT/A reduces upper limb spasticity in patients post‐stroke, but the improvement in functional ability remains to be established. This gap needs to be filled by new studies to assess the effect of BoNT in the context of multidisciplinary patient management. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Elia, Antonio Emanuele" sort="Elia, Antonio Emanuele" uniqKey="Elia A" first="Antonio Emanuele" last="Elia">Antonio Emanuele Elia</name></noRegion><name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name><name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name><name sortKey="Calandrella, Daniela" sort="Calandrella, Daniela" uniqKey="Calandrella D" first="Daniela" last="Calandrella">Daniela Calandrella</name><name sortKey="Calandrella, Daniela" sort="Calandrella, Daniela" uniqKey="Calandrella D" first="Daniela" last="Calandrella">Daniela Calandrella</name><name sortKey="Elia, Antonio Emanuele" sort="Elia, Antonio Emanuele" uniqKey="Elia A" first="Antonio Emanuele" last="Elia">Antonio Emanuele Elia</name><name sortKey="Filippini, Graziella" sort="Filippini, Graziella" uniqKey="Filippini G" first="Graziella" last="Filippini">Graziella Filippini</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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