OnabotulinumtoxinA muscle injection patterns in adult spasticity: A systematic literature review

BMC Neurology

Volumn 13, Issue , 2013, Pages

  Nalysnyk, Luba ^a   Papapetropoulos, Spyridon ^b   Rotella, Philip ^c   Simeone, Jason C ^c   Alter, Katharine E ^d,e   Esquenazi, Alberto ^f  

^a UNITED BIOSOURCE CORPORATION   (United States)

^b ALLERGAN INC   (United States)

^c EVIDERA   (United States)

^d Mount Washington Pediatric Hospital   (United States)

^e NATIONAL INSTITUTES OF HEALTH   (United States)

^f ALBERT EINSTEIN MEDICAL CENTER   (United States)

Author keywords

Botulinum toxin; Injection patterns; Muscles; OnabotulinumtoxinA; Spasticity

Indexed keywords

BOTULINUM TOXIN A; BOTULINUM TOXIN B;

ARTICLE; BICEPS BRACHII MUSCLE; CLINICAL TRIAL (TOPIC); DRUG DISTRIBUTION; DRUG EFFICACY; DRUG SAFETY; FLEXOR CARPI RADIALIS MUSCLE; FLEXOR CARPI ULNARIS MUSCLE; FLEXOR DIGITORUM PROFUNDUS MUSCLE; FLEXOR DIGITORUM SUPERFICIALIS MUSCLE; FLEXOR MUSCLE; GASTROCNEMIUS MUSCLE; HUMAN; RANDOMIZED CONTROLLED TRIAL (TOPIC); SOLEUS MUSCLE; SPASTICITY; SUBSCAPULARIS MUSCLE; SYSTEMATIC REVIEW; TIBIALIS POSTERIOR MUSCLE; TRAUMATIC BRAIN INJURY;

ADULT; BOTULINUM TOXINS, TYPE A; CLINICAL TRIALS AS TOPIC; DATABASES, BIBLIOGRAPHIC; HUMANS; INJECTIONS, INTRAMUSCULAR; MUSCLE SPASTICITY; NEUROMUSCULAR AGENTS;

EID: 84883609365     PISSN: None     EISSN: 14712377     Source Type: Journal    
DOI: 10.1186/1471-2377-13-118     Document Type: Article

References (90)

1. Lance JW. The control of muscle tone, reflexes, and movement: Robert Wartenberg Lecture. Neurology 1980, 30(12):1303-1313. 10.1212/WNL.30.12.1303, 7192811.
2. Bergfeldt U, Borg K, Kullander K, Julin P. Focal spasticity therapy with botulinum toxin: effects on function, activities of daily living and pain in 100 adult patients. J Rehabil Med 2006, 38(3):166-171. 10.1080/16501970500415348, 16702083.
3. Mostoufi SA. Spasticity and its management. Pain Manage Rounds 2005, 2(5):1-6.
4. Esquenazi A. Improvements in healthcare and cost benefits associated with botulinum toxin treatment of spasticity and muscle overactivity. Eur J Neurol 2006, 13(Suppl 4):27-34.
5. O'Brien CF. Treatment of spasticity with botulinum toxin. Clin J Pain 2002, 18(6 Suppl):S182-S190.
6. Esquenazi A. Falls and fractures in older post-stroke patients with spasticity: consequences and drug treatment considerations. Clin Geriatr 2004, 12(8):27-35.
7. Simpson DM, Gracies JM, Graham HK, Miyasaki JM, Naumann M, Russman B, Simpson LL, So Y. Assessment: botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the therapeutics and technology assessment subcommittee of the American academy of neurology. Neurology 2008, 70(19):1691-1698. 10.1212/01.wnl.0000311391.00944.c4, 18458229.
8. Yelnik AP, Simon O, Parratte B, Gracies JM. How to clinically assess and treat muscle overactivity in spastic paresis. J Rehabil Med 2010, 42(9):801-807. 10.2340/16501977-0613, 20878038.
9. Brainin M, Norrving B, Sunnerhagen KS, Goldstein LB, Cramer SC, Donnan GA, Duncan PW, Francisco G, Good D, Graham G, et al. Poststroke chronic disease management: towards improved identification and interventions for poststroke spasticity-related complications. Int J Stroke 2011, 6(1):42-46. 10.1111/j.1747-4949.2010.00539.x, 21205240.
10. Bhakta BB. Management of spasticity in stroke. Br Med Bull 2000, 56(2):476-485. 10.1258/0007142001903111, 11092096.
11. Ryu JS, Lee JW, Lee SI, Chun MH. Factors predictive of spasticity and their effects on motor recovery and functional outcomes in stroke patients. Top Stroke Rehabil 2010, 17(5):380-388. 10.1310/tsr1705-380, 21131263.
12. Thompson AJ, Jarrett L, Lockley L, Marsden J, Stevenson VL. Clinical management of spasticity. J Neurol Neurosurg Psychiatry 2005, 76(4):459-463. 10.1136/jnnp.2004.035972, 1739594, 15774425.
13. Woldag H, Hummelsheim H. Is the reduction of spasticity by botulinum toxin a beneficial for the recovery of motor function of arm and hand in stroke patients?. Eur Neurol 2003, 50(3):165-171. 10.1159/000073058, 14530623.
14. Albanese A. Terminology for preparations of botulinum neurotoxins: what a difference a name makes. JAMA 2011, 305(1):89-90. 10.1001/jama.2010.1937, 21205970.
15. Product Correspondence - Final SPL for approved BLA STN 103000/5189 [http://www.accessdata.fda.gov/drugsatfda_docs/appletter/2010/103000s5189ltr.pdf], Product Correspondence - Final SPL for approved BLA STN 103000/5189.
16. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med 1997, 126(5):376-380. 10.7326/0003-4819-126-5-199703010-00006, 9054282.
17. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions 4.2.1 [updated December 2003] 2004, Chichester, UK: John Wiley & Sons, Ltd.
18. Kirazli Y, On AY, Kismali B, Aksit R. Comparison of phenol block and botulinus toxin type A in the treatment of spastic foot after stroke: a randomized, double-blind trial. Am J Phys Med Rehabil 1998, 77(6):510-515. 10.1097/00002060-199811000-00012, 9862538.
19. On AY, Kirazli Y, Kismali B, Aksit R. Mechanisms of action of phenol block and botulinus toxin Type A in relieving spasticity: electrophysiologic investigation and follow-up. Am J Phys Med Rehabil 1999, 78(4):344-349. 10.1097/00002060-199907000-00010, 10418840.
20. Lagalla G, Danni M, Reiter F, Ceravolo MG, Provinciali L. Post-stroke spasticity management with repeated botulinum toxin injections in the upper limb. Am J Phys Med Rehabil 2000, 79(4):377-384. quiz 391-374, 10.1097/00002060-200007000-00010, 10892624.
21. Reiter F, Danni M, Ceravolo MG, Provinciali L. Disability changes after treatment of upper limb spasticity with botulinum toxin. Neurorehabilitation and Neural Repair 1996, 10(1):47-52.
22. Chen JJ, Wu YN, Huang SC, Lee HM, Wang YL. The use of a portable muscle tone measurement device to measure the effects of botulinum toxin type a on elbow flexor spasticity. Arch Phys Med Rehabil 2005, 86(8):1655-1660. 10.1016/j.apmr.2005.03.019, 16084822.
23. Lee HM, Chen JFJ, Wu YN, Wang YL, Huang SC, Piotrkiewicz M. Time course analysis of the effects of botulinum toxin type A on elbow spasticity based on biomechanic and electromyographic parameters. Archives of Physical Medicine and Rehabilitation 2008, 89(4):692-699. 10.1016/j.apmr.2007.08.166, 18374000.
24. Rousseaux M, Buisset N, Daveluy W, Kozlowski O, Blond S. Comparison of botulinum toxin injection and neurotomy in patients with distal lower limb spasticity. Eur J Neurol 2008, 15(5):506-511. 10.1111/j.1468-1331.2008.02112.x, 18325022.
25. Rousseaux M, Compere S, Launay MJ, Kozlowski O. Variability and predictability of functional efficacy of botulinum toxin injection in leg spastic muscles. J Neurol Sci 2005, 232(1-2):51-57.
26. Albani G, Cimolin V, Galli M, Vimercati S, Bar D, Campanelli L, Gandolfi R, Lombardi R, Mauro A. Use of surface EMG for evaluation of upper limb spasticity during botulinum toxin therapy in stroke patients. Funct Neurol 2010, 25(2):103-107.
27. Bayram S, Sivrioglu K, Karli N, Ozcan O. Low-dose botulinum toxin with short-term electrical stimulation in poststroke spastic drop foot: a preliminary study. Am J Phys Med Rehabil 2006, 85(1):75-81. 10.1097/01.phm.0000193505.85874.61, 16357552.
28. Bhakta BB, Cozens JA, Bamford JM, Chamberlain MA. Use of botulinum toxin in stroke patients with severe upper limb spasticity. J Neurol Neurosurg Psychiatry 1996, 61(1):30-35. 10.1136/jnnp.61.1.30, 486452, 8676154.
29. Brashear A, Gordon MF, Elovic E, Kassicieh VD, Marciniak C, Do M, Lee CH, Jenkins S, Turkel C. Intramuscular injection of Botulinum toxin for the treatment of wrist and finger spasticity after a stroke. N Engl J Med 2002, 347(6):395-400. 10.1056/NEJMoa011892, 12167681.
30. Carda S, Molteni F. Taping versus electrical stimulation after Botulinum toxin type A injection for wrist and finger spasticity. A case-control study. Clin Rehabil 2005, 19(6):621-626. 10.1191/0269215505cr879oa, 16180597.
31. Childers MK, Brashear A, Jozefczyk P, Reding M, Alexander D, Good D, Walcott JM, Jenkins SW, Turkel C, Molloy PT. Dose-dependent response to intramuscular Botulinum toxin type A for upper-limb spasticity in patients after a stroke. Arch Phys Med Rehabil 2004, 85(7):1063-1069. 10.1016/j.apmr.2003.10.015, 15241751.
32. Childers MK, Stacy M, Cooke DL, Stonnington HH. Comparison of two injection techniques using Botulinum toxin in spastic hemiplegia. Am J Phys Med Rehabil 1996, 75(6):462-469. 10.1097/00002060-199611000-00013, 8985111.
33. de Boer KS, Arwert HJ, de Groot JH, Meskers CGM, Mishre ADR, Arendzen JH. Shoulder pain and external rotation in spastic hemiplegia do not improve by injection of Botulinum toxin A into the subscapular muscle. Journal of Neurology Neurosurgery and Psychiatry 2008, 79(5):581-583.
34. Dunne JW, Heye N, Dunne SL. Treatment of chronic limb spasticity with Botulinum toxin A. J Neurol Neurosurg Psychiatry 1995, 58(2):232-235. 10.1136/jnnp.58.2.232, 1073325, 7876859.
35. Esquenazi A, Mayer N, Garreta R. Influence of Botulinum toxin type A treatment of elbow flexor spasticity on hemiparetic gait. American Journal of Physical Medicine & Rehabilitation 2008, 87(4):305-310. 10.1097/PHM.0b013e318168d36c, 23594573.
36. Farina S, Migliorini C, Gandolfi M, Bertolasi L, Casarotto M, Manganotti P, Fiaschi A, Smania N. Combined effects of Botulinum toxin and casting treatments on lower limb spasticity after stroke. Funct Neurol 2008, 23(2):87-91.
37. Fock J, Galea MP, Stillman BC, Rawicki B, Clark M. Functional outcome following Botulinum toxin A injection to reduce spastic equinus in adults with traumatic brain injury. Brain Inj 2004, 18(1):57-63. 10.1080/0269905031000149498, 14660236.
38. Francisco GE, Boake C, Vaughn A. Botulinum toxin in upper limb spasticity after acquired brain injury: a randomized trial comparing dilution techniques. Am J Phys Med Rehabil 2002, 81(5):355-363. 10.1097/00002060-200205000-00007, 11964576.
39. Giovannelli M, Borriello G, Castri P, Prosperini L, Pozzilli C. Early physiotherapy after injection of Botulinum toxin increases the beneficial effects on spasticity in patients with multiple sclerosis. Clin Rehabil 2007, 21(4):331-337. 10.1177/0269215507072772, 17613573.
40. Girlanda P, Quartarone A, Sinicropi S, Nicolosi C, Roberto ML, Picciolo G, Macaione V, Battaglia F, Ruggeri M, Messina C. Botulinum toxin in upper limb spasticity: study of reciprocal inhibition between forearm muscles. Neuroreport 1997, 8(14):3039-3044. 10.1097/00001756-199709290-00008, 9331911.
41. Gracies JM, Lugassy M, Weisz DJ, Vecchio M, Flanagan S, Simpson DM. Botulinum toxin dilution and endplate targeting in spasticity: a double-blind controlled study. Archives of Physical Medicine and Rehabilitation 2009, 90(1):9-16. 10.1016/j.apmr.2008.04.030, 19154823.
42. Grazko MA, Polo KB, Jabbari B. Botulinum toxin A for spasticity, muscle spasms, and rigidity. Neurology 1995, 45(4):712-717. 10.1212/WNL.45.4.712, 7723960.
43. Hecht MJ, Stolze H, Auf Dem Brinke M, Giess R, Treig T, Winterholler M, Wissel J. Botulinum neurotoxin type A injections reduce spasticity in mild to moderate hereditary spastic paraplegia - report of 19 cases. Movement Disorders 2008, 23(2):228-233. 10.1002/mds.21809, 17999430.
44. Henzel MK, Munin MC, Niyonkuru C, Skidmore ER, Weber DJ, Zafonte RD. Comparison of surface and ultrasound localization to identify forearm flexor muscles for Botulinum toxin injections. PM R 2010, 2(7):642-646. 10.1016/j.pmrj.2010.05.002, 20659720.
45. Hesse S, Krajnik J, Luecke D, Jahnke MT, Gregoric M, Mauritz KH. Ankle muscle activity before and after Botulinum toxin therapy for lower limb extensor spasticity in chronic hemiparetic patients. Stroke 1996, 27(3):455-460. 10.1161/01.STR.27.3.455, 8610313.
46. Hesse S, Lucke D, Malezic M, Bertelt C, Friedrich H, Gregoric M, Mauritz KH. Botulinum toxin treatment for lower limb extensor spasticity in chronic hemiparetic patients. J Neurol Neurosurg Psychiatry 1994, 57(11):1321-1324. 10.1136/jnnp.57.11.1321, 1073180, 7964805.
47. Jahangir AW, Tan HJ, Norlinah MI, Nafisah WY, Ramesh S, Hamidon BB, Raymond AA. Intramuscular injection of Botulinum toxin for the treatment of wrist and finger spasticity after stroke. Medical Journal of Malaysia 2007, 62(4):319-322.
48. Kaji R, Osako Y, Suyama K, Maeda T, Uechi Y, Iwasaki M. Botulinum toxin type A in post-stroke upper limb spasticity. Curr Med Res Opin 2010, 26(8):1983-1992. 10.1185/03007995.2010.497103, 20569068.
49. Kaji R, Osako Y, Suyama K, Maeda T, Uechi Y, Iwasaki M. Botulinum toxin type A in post-stroke lower limb spasticity: a multicenter, double-blind, placebo-controlled trial. J Neurol 2010, 257(8):1330-1337. 10.1007/s00415-010-5526-3, 2910313, 20358216.
50. Karadag-Saygi E, Cubukcu-Aydoseli K, Kablan N, Ofluoglu D. The role of kinesiotaping combined with Botulinum toxin to reduce plantar flexors spasticity after stroke. Topics in Stroke Rehabilitation 2010, 17(4):318-322. 10.1310/tsr1704-318, 20826420.
51. Khamees MF, Kondeva M, Eyadeh AA, Karar AH. Our experience with intramuscular injections of Botulinum toxin A for the treatment of upper limb flexors spasticity after stroke. Kuwait Med J 2004, 36(2):117-121.
52. Levy CE, Giuffrida C, Richards L, Wu S, Davis S, Nadeau SE. Botulinum toxin a, evidence-based exercise therapy, and constraint-induced movement therapy for upper-limb hemiparesis attributable to stroke: a preliminary study. Am J Phys Med Rehabil 2007, 86(9):696-706. 10.1097/PHM.0b013e31813e2b4d, 17709993.
53. Lim EC, Ong BK, Seet RC. Botulinum toxin-A injections for spastic toe clawing. Parkinsonism Relat Disord 2006, 12(1):43-47. 10.1016/j.parkreldis.2005.06.008, 16198612.
54. Lim JY, Koh JH, Paik NJ. Intramuscular Botulinum toxin-A reduces hemiplegic shoulder pain: A randomized, double-blind, comparative study versus intraarticular triamcinolone acetonide. Stroke 2008, 39(1):126-131. 10.1161/STROKEAHA.107.484048, 18048857.
55. Link A, Kabus C, Haas J. Use of spasmography to assess the effects of Botulinum toxin type A in patients with lower-limb spasticity. European Journal of Neurology 1999, 6(SUPPL. 4):S69-S73.
56. Maanum G, Jahnsen R, Stanghelle JK, Sandvik L, Keller A. Effects of Botulinum toxin A in ambulant adults with spastic cerebral palsy: a randomized double-blind placebo controlled-trial. J Rehabil Med 2011, 43(4):338-347. 10.2340/16501977-0672, 21305227.
57. Manca M, Merlo A, Ferraresi G, Cavazza S, Marchi P. Botulinum toxin type A versus phenol. A clinical and neurophysiological study in the treatment of ankle clonus. Eur J Phys Rehabil Med 2010, 46(1):11-18.
58. Mancini F, Sandrini G, Moglia A, Nappi G, Pacchetti C. A randomised, double-blind, dose-ranging study to evaluate efficacy and safety of three doses of Botulinum toxin type A (Botox) for the treatment of spastic foot. Neurol Sci 2005, 26(1):26-31. 10.1007/s10072-005-0378-9, 15877184.
59. Marciniak C, Rader L, Gagnon C. The use of Botulinum toxin for spasticity after spinal cord injury. American Journal of Physical Medicine & Rehabilitation 2008, 87(4):312-317. 10.1097/PHM.0b013e318168ceaf, 23594573.
60. Mayer NH, Whyte J, Wannstedt G, Ellis CA. Comparative impact of 2 Botulinum toxin injection techniques for elbow flexor hypertonia. Arch Phys Med Rehabil 2008, 89(5):982-987. 10.1016/j.apmr.2007.10.022, 18452749.
61. Miscio G, Del Conte C, Pianca D, Colombo R, Panizza M, Schieppati M, Pisano F. Botulinum toxin in post-stroke patients: stiffness modifications and clinical implications. J Neurol 2004, 251(2):189-196. 10.1007/s00415-004-0297-3, 14991354.
62. Mohammadi B, Balouch SA, Dengler R, Kollewe K. Long-term treatment of spasticity with Botulinum toxin type A: an analysis of 1221 treatments in 137 patients. Neurol Res 2010, 32(3):309-313. 10.1179/016164109X12478302362734, 19726016.
63. Molteni F. Botulinum toxin and rehabilitation programs in lower limb spasticity. Eur J Neurol 1995, 2(3):61-67.
64. Novak AC, Olney SJ, Bagg S, Brouwer B. Gait changes following Botulinum toxin A treatment in stroke. Top Stroke Rehabil 2009, 16(5):367-376. 10.1310/tsr1605-367, 19903655.
65. Opara J, Hordynska E, Swoboda A. Effectiveness of Botulinum toxin A in the treatment of spasticity of the lower extremities in adults - preliminary report. Ortop Traumatol Rehabil 2007, 9(3):277-285.
66. Pandyan AD, Vuadens P, van Wijck FM, Stark S, Johnson GR, Barnes MP. Are we underestimating the clinical efficacy of Botulinum toxin (type A)? Quantifying changes in spasticity, strength and upper limb function after injections of Botox to the elbow flexors in a unilateral stroke population. Clin Rehabil 2002, 16(6):654-660. 10.1191/0269215502cr536oa, 12392341.
67. Panizza M, Castagna M, di Summa A, Saibene L, Grioni G, Nilsson J. Functional and clinical changes in upper limb spastic patients treated with Botulinum toxin (BTX). Funct Neurol 2000, 15(3):147-155.
68. Pedreira G, Cardoso E, Melo A. Botulinum toxin type A for refractory post-stroke shoulder pain. Arq Neuropsiquiatr 2008, 66(2A):213-215. 10.1590/S0004-282X2008000200014, 18545785.
69. Reiter F, Danni M, Lagalla G, Ceravolo G, Provinciali L. Low-dose Botulinum toxin with ankle taping for the treatment of spastic equinovarus foot after stroke. Arch Phys Med Rehabil 1998, 79(5):532-535. 10.1016/S0003-9993(98)90068-5, 9596394.
70. Restivo DA, Tinazzi M, Patti F, Palmeri A, Maimone D. Botulinum toxin treatment of painful tonic spasms in multiple sclerosis. Neurology 2003, 61(5):719-720.
71. Richardson D, Sheean G, Werring D, Desai M, Edwards S, Greenwood R, Thompson A. Evaluating the role of Botulinum toxin in the management of focal hypertonia in adults. J Neurol Neurosurg Psychiatry 2000, 69(4):499-506. 10.1136/jnnp.69.4.499, 1737149, 10990511.
72. Robertson JVG, Pradon D, Bensmail D, Fermanian C, Bussel B, Roche N. Relevance of Botulinum toxin injection and nerve block of rectus femoris to kinematic and functional parameters of stiff knee gait in hemiplegic adults. Gait & Posture 2009, 29(1):108-112. 10.1016/j.gaitpost.2008.07.005, 24052577.
73. Rousseaux M, Kozlowski O, Froger J. Efficacy of Botulinum toxin A in upper limb function of hemiplegic patients. J Neurol 2002, 249(1):76-84. 10.1007/PL00007851, 11954872.
74. Sampaio C, Ferreira JJ, Pinto AA, Crespo M, Ferro JM, Castro-Caldas A. Botulinum toxin type A for the treatment of arm and hand spasticity in stroke patients. Clin Rehabil 1997, 11(1):3-7. 10.1177/026921559701100102, 9065354.
75. Simpson DM, Alexander DN, O'Brien CF, Tagliati M, Aswad AS, Leon JM, Gibson J, Mordaunt JM, Monaghan EP. Botulinum toxin type A in the treatment of upper extremity spasticity: a randomized, double-blind, placebo-controlled trial. Neurology 1996, 46(5):1306-1310. 10.1212/WNL.46.5.1306, 8628472.
76. Simpson DM, Gracies JM, Yablon SA, Barbano R, Brashear A. Botulinum neurotoxin versus tizanidine in upper limb spasticity: a placebo-controlled study. J Neurol Neurosurg Psychiatry 2009, 80(4):380-385.
77. Slawek J, Bogucki A, Reclawowicz D. Botulinum toxin type A for upper limb spasticity following stroke: an open-label study with individualised, flexible injection regimens. Neurol Sci 2005, 26(1):32-39. 10.1007/s10072-005-0379-8, 15877185.
78. Snow BJ, Tsui JK, Bhatt MH, Varelas M, Hashimoto SA, Calne DB. Treatment of spasticity with Botulinum toxin: a double-blind study. Ann Neurol 1990, 28(4):512-515. 10.1002/ana.410280407, 2252363.
79. Stampacchia G, Bradaschia E, Rossi B. Change of stretch reflex threshold in spasticity: effect of Botulinum toxin injections. Arch Ital Biol 2004, 142(3):265-273.
80. Stoquart GG, Detrembleur C, Palumbo S, Deltombe T, Lejeune TM. Effect of Botulinum toxin injection in the rectus femoris on stiff-knee gait in people with stroke: A prospective observational study. Archives of Physical Medicine and Rehabilitation 2008, 89(1):56-61. 10.1016/j.apmr.2007.08.131, 18164331.
81. Suputtitada A. Local Botulinum toxin type A injections in the treatment of spastic toes. Am J Phys Med Rehabil 2002, 81(10):770-775. 10.1097/00002060-200210000-00009, 12362118.
82. Trompetto C, Bove M, Avanzino L, Francavilla G, Berardelli A, Abbruzzese G. Intrafusal effects of Botulinum toxin in post-stroke upper limb spasticity. European Journal of Neurology 2008, 15(4):367-370. 10.1111/j.1468-1331.2008.02076.x, 18266870.
83. Turhanoglu AD, Karabulut Z, Bayram H, Turhanoglu S, Erdogan F, Apak I, Yayla V. Botulinum toxin A in the treatment of spasticity - An open label study. Journal of Back and Musculoskeletal Rehabilitation 2002, 16(2-3):51-56.
84. Turkel CC, Bowen B, Liu J, Brin MF. Pooled analysis of the safety of Botulinum toxin type A in the treatment of poststroke spasticity. Arch Phys Med Rehabil 2006, 87(6):786-792. 10.1016/j.apmr.2006.02.015, 16731213.
85. Verplancke D, Snape S, Salisbury CF, Jones PW, Ward AB. A randomized controlled trial of Botulinum toxin on lower limb spasticity following acute acquired severe brain injury. Clin Rehabil 2005, 19(2):117-125. 10.1191/0269215505cr827oa, 15759526.
86. Wang HC, Hsieh LF, Chi WC, Lou SM. Effect of intramuscular Botulinum toxin injection on upper limb spasticity in stroke patients. Am J Phys Med Rehabil 2002, 81(4):272-278. 10.1097/00002060-200204000-00005, 11953544.
87. Weber DJ, Skidmore ER, Niyonkuru C, Chang CL, Huber LM, Munin MC. Cyclic functional electrical stimulation does not enhance gains in hand grasp function when used as an adjunct to onaBotulinumtoxinA and task practice therapy: a single-blind, randomized controlled pilot study. Arch Phys Med Rehabil 2010, 91(5):679-686. 10.1016/j.apmr.2010.01.010, 2880820, 20434603.
88. Yaar E, Tok F, Safaz I, Balaban B, Yilmaz B, Alaca R. The efficacy of serial casting after Botulinum toxin type A injection in improving equinovarus deformity in patients with chronic stroke. Brain Injury 2010, 24(5):736-739. 10.3109/02699051003610524, 20334469.
89. Yablon SA, Agana BT, Ivanhoe CB, Boake C. Botulinum toxin in severe upper extremity spasticity among patients with traumatic brain injury: an open-labeled trial. Neurology 1996, 47(4):939-944. 10.1212/WNL.47.4.939, 8857723.
90. Yelnik AP, Colle FM, Bonan IV, Lamotte DR. Disabling overactivity of the extensor hallucis longus after stroke: clinical expression and efficacy of Botulinum toxin type A. Arch Phys Med Rehabil 2003, 84(1):147-149. 10.1053/apmr.2003.50077, 12589637.