Rehabilitation Therapies After Botulinum Toxin-A Injection to Manage Limb Spasticity: A Systematic Review

被引:58
作者
Kinnear, Bianca Z. [1 ]
Lannin, Natasha A. [2 ,3 ]
Cusick, Anne [1 ]
Harvey, Lisa A. [4 ]
Rawicki, Barry [5 ]
机构
[1] Univ Wollongong, Fac Social Sci, Wollongong, NSW 2522, Australia
[2] La Trobe Univ, Dept Occupat Therapy, Bundoora, Vic 3086, Australia
[3] Alfred Hlth Melbourne, Occupat Therapy Dept, Melbourne, Vic, Australia
[4] Univ Sydney, Sydney Med Sch, Kolling Inst, Rehabil Studies Unit, Sydney, NSW 2006, Australia
[5] Monash Univ, Fac Med Nursing & Hlth Sci, Melbourne, Vic 3004, Australia
来源
PHYSICAL THERAPY | 2014年 / 94卷 / 11期
关键词
TERM ELECTRICAL-STIMULATION; DOUBLE-BLIND; STROKE; QUALITY; ADJUNCT;
D O I
10.2522/ptj.20130408
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Background. Botulinum toxin A (BoNT-A) injections are increasingly used to treat muscle spasticity and are often complemented by adjunctive rehabilitation therapies; however, little is known about the effect of therapy after injection. Purpose. The aim of this study was to identify and summarize evidence on rehabilitation therapies used after BoNT-A injections to improve motor function in adults with neurological impairments. Data Sources. Searches were conducted in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, National Research Register, metaRegistry of Controlled Trials, PEDro, and OTseeker. Study Selection. Randomized and quasi-randomized controlled trials were considered for inclusion. Participants with neurological impairments received BoNT-A to treat focal spasticity in limbs, with rehabilitation interventions provided to experimental groups only. Primary outcome measures were joint mobility, function of the affected limb, and spasticity. Eleven studies with 234 participants, most of whom had stroke, were included in the review. Data Extraction. Two reviewers extracted study details and data. Data Synthesis. Methodological quality was rated using the PEDro scale. Both fixed-effects and random-effects models were used to calculate effect size. Results. studies were of variable quality: 3 were poor (PEDro score 1 to 4), and 8 were moderate (PEDro score 6 to 7). No study investigated effects for longer than 24 weeks (6 months). Included trials presented 9 therapy types, including ergometer cycling, electrical stimulation, stretch (casting, splinting, taping, or manual or exercise-induced stretch), constraint-induced movement therapy, task-specific motor training, and exercise programs. Statistical findings suggest that combined therapy and BoNT-A is slightly more effective than BoNT-A alone. Conclusion. Evidence relating to impact of adjunct therapy is available, but the heterogeneity of studies limits the opportunity to demonstrate overall impact. Researchers need to consider the benefits of greater consistency in study approaches and measures so that meaningful evaluations of overall adjunct therapy effects can be made.
引用
收藏
页码:1569 / 1581
页数:13
相关论文
共 32 条
[1]
[Anonymous], REV MAN REVMAN 5 0
[2]
[Anonymous], COCHRANE HDB SYSTEMA
[3]
[Anonymous], FDN PRACTICE OCCUPAT
[4]
[Anonymous], INT J STROKE S1
[5]
[Anonymous], 2010, CLIN GUID STROK MAN
[6]
[Anonymous], HAND CLIN
[7]
Impact of botulinum toxin type A on disability and carer burden due to arm spasticity after stroke: a randomised double blind placebo controlled trial [J].
Bhakta, BB ;
Cozens, JA ;
Chamberlain, MA ;
Bamford, JM .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2000, 69 (02) :217-221
[8]
Botulinum toxin type A for the treatment of the upper limb spasticity after stroke - A meta-analysis [J].
Cardoso, E ;
Rodrigues, B ;
Lucena, R ;
de Oliveira, IR ;
Pedreira, G ;
Melo, A .
ARQUIVOS DE NEURO-PSIQUIATRIA, 2005, 63 (01) :30-33
[9]
Effect of simultaneous Botulinum toxin injections into several muscles on impairment, activity, participation, and quality of life among stroke patients presenting with a stiff knee gait [J].
Caty, Gilles D. ;
Detrembleur, Christine ;
Bleyenheuft, Corinne ;
Deltombe, Thierry ;
Lejeune, Thierry M. .
STROKE, 2008, 39 (10) :2803-2808
[10]
Effect of Repetitive Arm Cycling Following Botulinum Toxin Injection for Poststroke Spasticity: Evidence From fMRI [J].
Diserens, Karin ;
Ruegg, Dieter ;
Kleiser, Raimund ;
Hyde, Sandrine ;
Perret, Nicolas ;
Vuadens, Philippe ;
Fornari, Eleonora ;
Vingerhoets, Francois ;
Seitz, Ruediger J. .
NEUROREHABILITATION AND NEURAL REPAIR, 2010, 24 (08) :753-762