Adjuvant treatments associated with botulinum toxin injection for managing spasticity: An overview of the literature.


Journal

Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773

Informations de publication

Date de publication:
Jul 2019
Historique:
received: 11 12 2017
revised: 20 08 2018
accepted: 20 08 2018
pubmed: 17 9 2018
medline: 28 1 2020
entrez: 17 9 2018
Statut: ppublish

Résumé

A wide range of adjunct therapies after botulinum toxin administration have been proposed. The aim of the present paper is to provide an overview of major writings dealing with adjuvant (non-pharmacological) treatments associated with botulinum toxin for managing spasticity in order to provide some up-to-date information about the usefulness of the most commonly used procedures. The literature in PubMed was searched with the MeSH terms botulinum toxins, muscle spasticity, physical therapy modalities, and rehabilitation. The results were limited to studies focusing on adjuvant treatments associated with botulinum toxin for managing spasticity. We excluded papers on the use of non-drug treatments for spasticity not associated with botulinum toxin serotype A (BoNT-A) injection. Relevant literature known to the authors along with this complementary search represented the basis for this overview of the literature. Adhesive taping and casting effectively improved the botulinum toxin effect in patients with upper- and lower-limb spasticity. There is level 1 evidence that casting is better than taping for outcomes including spasticity, range of motion and gait. However, consensus about their most appropriate timing, duration, target and material is lacking. In terms of physical modalities combined with botulinum toxin injection, we found level 1 evidence that extracorporeal shock wave therapy is better than electrical stimulation for some post-injection outcomes including spasticity and pain. Furthermore, electrical stimulation of injected muscles might be useful to boost the toxin effect. However, the best stimulation protocol has not been defined. In addition, we found level 2b evidence that whole-body vibration therapy might reduce spasticity with cerebral palsy. Future research in this field should focus on investigating the most appropriate post-injection treatment protocol for each goal to achieve.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
A wide range of adjunct therapies after botulinum toxin administration have been proposed. The aim of the present paper is to provide an overview of major writings dealing with adjuvant (non-pharmacological) treatments associated with botulinum toxin for managing spasticity in order to provide some up-to-date information about the usefulness of the most commonly used procedures.
METHODS METHODS
The literature in PubMed was searched with the MeSH terms botulinum toxins, muscle spasticity, physical therapy modalities, and rehabilitation. The results were limited to studies focusing on adjuvant treatments associated with botulinum toxin for managing spasticity. We excluded papers on the use of non-drug treatments for spasticity not associated with botulinum toxin serotype A (BoNT-A) injection. Relevant literature known to the authors along with this complementary search represented the basis for this overview of the literature.
RESULTS RESULTS
Adhesive taping and casting effectively improved the botulinum toxin effect in patients with upper- and lower-limb spasticity. There is level 1 evidence that casting is better than taping for outcomes including spasticity, range of motion and gait. However, consensus about their most appropriate timing, duration, target and material is lacking. In terms of physical modalities combined with botulinum toxin injection, we found level 1 evidence that extracorporeal shock wave therapy is better than electrical stimulation for some post-injection outcomes including spasticity and pain. Furthermore, electrical stimulation of injected muscles might be useful to boost the toxin effect. However, the best stimulation protocol has not been defined. In addition, we found level 2b evidence that whole-body vibration therapy might reduce spasticity with cerebral palsy.
CONCLUSION CONCLUSIONS
Future research in this field should focus on investigating the most appropriate post-injection treatment protocol for each goal to achieve.

Identifiants

pubmed: 30219307
pii: S1877-0657(18)31445-3
doi: 10.1016/j.rehab.2018.08.004
pii:
doi:

Substances chimiques

Neuromuscular Agents 0
Botulinum Toxins, Type A EC 3.4.24.69

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

291-296

Informations de copyright

Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Auteurs

Alessandro Picelli (A)

Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy. Electronic address: alessandro.picelli@univr.it.

Andrea Santamato (A)

Physical Medicine & Rehabilitation Section, 'OORR' Hospital, University of Foggia, Foggia, Italy.

Elena Chemello (E)

Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Nicoletta Cinone (N)

Physical Medicine & Rehabilitation Section, 'OORR' Hospital, University of Foggia, Foggia, Italy.

Carlo Cisari (C)

Health Sciences Department, Università del Piemonte Orientale, Novara, Italy.

Marialuisa Gandolfi (M)

Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy.

Maurizio Ranieri (M)

Physical Medicine & Rehabilitation Section, 'OORR' Hospital, University of Foggia, Foggia, Italy.

Nicola Smania (N)

Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy.

Alessio Baricich (A)

Health Sciences Department, Università del Piemonte Orientale, Novara, Italy.

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Classifications MeSH