The profile of patients and current practice of treatment of upper limb muscle spasticity with botulinum toxin type A: an international survey.
To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31 countries were studied. Most patients were over 40 years old and had a stroke. Improvement of active function was the most frequent treatment goal in the first 3 months after the onset of upper limb spasticity, but was less common than passive function in the chronic stage. Pain relief was a common goal in both the stages. As a rule, clinicians intended to assess the effectiveness of treatment with impairment level scales. Functional outcome measures seem to be rarely used in clinical practice. The use of these measures should be encouraged to assess whether the reduction in muscle tone translates into functional benefit to patients and their caregivers.
Stroke Unit, Mount Gould Hospital, Plymouth, UK. magid.bakheit@plymouth.nhs.uk
Abdel Magid
AM
Bakheit
Benjamin
B
Zakine
Pascal
P
Maisonobe
Claire
C
Aymard
Klemens
K
Fhedoroff
Harold
H
Hefter
Jorge
J
Jacinto
Wolfgang H
WH
Jost
Franco
F
Molteni
Henk
H
Stam
Lynne
L
Turner-Stokes
Jorg
J
Wissel
D000203:Activities of Daily Living; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006429:Hemiplegia / Q000150:complications / Q000534:rehabilitation; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy; D016059:Range of Motion, Articular / Q000187:drug effects; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA