title: The impact of post-stroke spasticity and botulinum toxin on standing balance: a systematic review.
abstract: Although falls, balance impairment, and spasticity are common post-stroke, their interrelationship remains unclear. We review the literature for a) a relationship between spasticity and balance and b) the effect of botulinum toxin injections on balance. Electronic databases were searched based on two criteria: a) studies assessing balance in subjects with spasticity and b) studies examining the effect of botulinum toxin on balance. The primary findings were a) balance is impaired in subjects with spasticity, but only one study assessed relationship between spasticity and balance; and b) four studies reported that balance improves following botulinum treatment for limb spasticity. Persons with spasticity demonstrate impaired balance, but the correlation between spasticity and balance has not been adequately assessed in the literature. Evidence for balance changes following botulinum toxin is weak because of lack of randomization, control group comparison, objective balance assessment measures, and standard clinical scales.
authors: Spasticity Research Program, West Park Healthcare Centre, Toronto, ON, Canada.
authors: Chetan Purushottam
authors: CP
authors: Phadke
authors: Farooq
authors: F
authors: Ismail
authors: Chris
authors: C
authors: Boulias
authors: William
authors: W
authors: Gage
authors: George
authors: G
authors: Mochizuki
mesh_terms: D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D009128:Muscle Spasticity / Q000209:etiology*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D004856:Postural Balance / Q000187:drug effects* / Q000502:physiology*; D020521:Stroke / Q000150:complications*
chemical_list: D009465:Neuromuscular Agents; D001905:Botulinum Toxins