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Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries

Purpose: Describe real-life practice and outcomes in the management of post-stroke upper limb spasticity with botulinum toxin A (BoNT-A) in Asian settings. Methods: Subgroup analysis of a prospective, observational study (NCT01020500) of adult patients (>= 18 years) with post-stroke upper limb sp...

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Main Authors: Rosales, Raymond L., Chia, Nicholas V. C., Kumthornthip, Witsanu, Goh, Khean Jin, Mak, Choon Soon, Kong, Keng He, Ng, Yee Sien, Chou, Li Wei, Flordelis, M. Jeanne, Do, Thuy, Maisonobe, Pascal, Li, Leonard S. W., Suputtitada, Areerat
Format: Article
Published: Frontiers Media 2024
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R Medicine
Online Access:http://eprints.um.edu.my/45324/
https://doi.org/10.3389/fneur.2024.1335365
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spelling my.um.eprints.453242024-10-08T08:48:51Z http://eprints.um.edu.my/45324/ Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries Rosales, Raymond L. Chia, Nicholas V. C. Kumthornthip, Witsanu Goh, Khean Jin Mak, Choon Soon Kong, Keng He Ng, Yee Sien Chou, Li Wei Flordelis, M. Jeanne Do, Thuy Maisonobe, Pascal Li, Leonard S. W. Suputtitada, Areerat R Medicine Purpose: Describe real-life practice and outcomes in the management of post-stroke upper limb spasticity with botulinum toxin A (BoNT-A) in Asian settings. Methods: Subgroup analysis of a prospective, observational study (NCT01020500) of adult patients (>= 18 years) with post-stroke upper limb spasticity presenting for routine spasticity management, including treatment with BoNT-A. The primary outcome was goal attainment as assessed using goal-attainment scaling (GAS). Patients baseline clinical characteristics and BoNT-A injection parameters are also described. Results: Overall, 51 patients from Asia were enrolled. Rates of comorbid cognitive and emotional problems were relatively low. Patients tended to have more severe distal limb spasticity and to prioritize active over passive function goals. Most (94.1%) patients in the subgroup were treated with abobotulinumtoxinA. For these patients, the median total dose was 500 units, and the most frequently injected muscles were the biceps brachii (83.3%), flexor carpi radialis (72.9%), and flexor digitorum profundus (66.7%). Overall, 74.5% achieved their primary goal and the mean GAS T score after one treatment cycle was 56.0 +/- 13.0, with a change from baseline of 20.9 +/- 14.3 (p < 0.001). The majority (96.1%) of Asian patients were rated as having improved. Conclusion: In the Asian treatment setting, BoNT-A demonstrated a clinically significant effect on goal attainment for the real-life management of upper limb spasticity following stroke. Frontiers Media 2024-04 Article PeerReviewed Rosales, Raymond L. and Chia, Nicholas V. C. and Kumthornthip, Witsanu and Goh, Khean Jin and Mak, Choon Soon and Kong, Keng He and Ng, Yee Sien and Chou, Li Wei and Flordelis, M. Jeanne and Do, Thuy and Maisonobe, Pascal and Li, Leonard S. W. and Suputtitada, Areerat (2024) Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries. Frontiers in Neurology, 15. p. 1335365. ISSN 1664-2295, DOI https://doi.org/10.3389/fneur.2024.1335365 <https://doi.org/10.3389/fneur.2024.1335365>. https://doi.org/10.3389/fneur.2024.1335365 10.3389/fneur.2024.1335365
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Rosales, Raymond L.
Chia, Nicholas V. C.
Kumthornthip, Witsanu
Goh, Khean Jin
Mak, Choon Soon
Kong, Keng He
Ng, Yee Sien
Chou, Li Wei
Flordelis, M. Jeanne
Do, Thuy
Maisonobe, Pascal
Li, Leonard S. W.
Suputtitada, Areerat
Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries
description Purpose: Describe real-life practice and outcomes in the management of post-stroke upper limb spasticity with botulinum toxin A (BoNT-A) in Asian settings. Methods: Subgroup analysis of a prospective, observational study (NCT01020500) of adult patients (>= 18 years) with post-stroke upper limb spasticity presenting for routine spasticity management, including treatment with BoNT-A. The primary outcome was goal attainment as assessed using goal-attainment scaling (GAS). Patients baseline clinical characteristics and BoNT-A injection parameters are also described. Results: Overall, 51 patients from Asia were enrolled. Rates of comorbid cognitive and emotional problems were relatively low. Patients tended to have more severe distal limb spasticity and to prioritize active over passive function goals. Most (94.1%) patients in the subgroup were treated with abobotulinumtoxinA. For these patients, the median total dose was 500 units, and the most frequently injected muscles were the biceps brachii (83.3%), flexor carpi radialis (72.9%), and flexor digitorum profundus (66.7%). Overall, 74.5% achieved their primary goal and the mean GAS T score after one treatment cycle was 56.0 +/- 13.0, with a change from baseline of 20.9 +/- 14.3 (p < 0.001). The majority (96.1%) of Asian patients were rated as having improved. Conclusion: In the Asian treatment setting, BoNT-A demonstrated a clinically significant effect on goal attainment for the real-life management of upper limb spasticity following stroke.
format Article
author Rosales, Raymond L.
Chia, Nicholas V. C.
Kumthornthip, Witsanu
Goh, Khean Jin
Mak, Choon Soon
Kong, Keng He
Ng, Yee Sien
Chou, Li Wei
Flordelis, M. Jeanne
Do, Thuy
Maisonobe, Pascal
Li, Leonard S. W.
Suputtitada, Areerat
author_facet Rosales, Raymond L.
Chia, Nicholas V. C.
Kumthornthip, Witsanu
Goh, Khean Jin
Mak, Choon Soon
Kong, Keng He
Ng, Yee Sien
Chou, Li Wei
Flordelis, M. Jeanne
Do, Thuy
Maisonobe, Pascal
Li, Leonard S. W.
Suputtitada, Areerat
author_sort Rosales, Raymond L.
title Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries
title_short Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries
title_full Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries
title_fullStr Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries
title_full_unstemmed Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries
title_sort botulinum toxin a injection for post-stroke upper limb spasticity and rehabilitation practices from centers across asian countries
publisher Frontiers Media
publishDate 2024
url http://eprints.um.edu.my/45324/
https://doi.org/10.3389/fneur.2024.1335365
_version_ 1814047540839972864
score 13.211869

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