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2. Urinary tract infections and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

Donzé, C., Papeix, C., Lebrun-Frénay, C., Collongues, N., de Seze, M., Dinh, A., Even, A., Scheiber-Nogueira, C., Bensa, C., Bourre, B., Carra-Dallière, C., Ciron, J., Cohen, M., Guennoc, A.M., Louapre, C., Lebreton, F., Michel, L., Maillart, E., Audoin, B., Ayrignac, X., Bernady, P., Brochet, B., Clavelou, P., Colamarino, R., Declemy, A., de Seze, J., Derache, N., Faucheux, J.-M., Heinzlef, O., Labauge, P., Laplaud, D., Lepage, E., Leray, E., Magy, L., Mathey, G., Mekies, C., Mondain, V., Planque, E., Pelletier, J., Pittion, S., Stankhof, B., Tournaire, P., Thouvenot, E., Vukusic, S., Wiertlevski, S., Zephir, H., Alchaar, H., Androdias, G., Benazet, M., Bensmail, D., Biotti, D., Blanchard-Dauphin, A., Bonnan, M., Boutière, C., Branger, P., Bresch, S., Bru, J.-P., Camdessanché, J.-P., Castel Canal, E., Coustans, M., Casez, O., Castan, B., Creange, A., Creisson, E., De Broucker, T., Depaz, R., Douay, X., Dulau, C., Durand-Dubief, F., Fagniez, O., Faucher, M., Floch, A., Fournier, M., Fromont, A., Gallien, P., Gamé, X., Gault, D., Gayou, A., Giroux, M., Gout, O., Grimaud, J., Hautecoeur, P., Kerbrat, A., Kremer, L., Kwiatkowski, A., Labeyrie, C., Lachaud, S., Lanctin-Garcia, C., Lanotte, L., Manchon, E., Maurousset, A., Milor, A.-M., Moisset, X., Mont-Cuquet, A., Moreau, T., Ouallet, J.-C., Patry, I., Peaureaux, D., Pouget, M.-C., Pourcher Martinez, V., Radot, C., Ruet, A., Saint-Val, C., Salmon, A., Taithe, F., Tatevin, P., Vaillant, M., Stahl, J.-P., Vuoto, F., Zaenker, C., and Lebrun-Frenay, C.

Published
2020
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4. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

Abadie, V., Achour, C., Ader, F., Alchaar, H., Alkhedr, A., Andreux, F., Androdias, G., Arjmand, R., Audoin, B., Audry, D., Aufauvre, D., Autreaux, C., Ayrignac, X., Bailbe, M., Benazet, M., Bensa, C., Bensmail, D., Berger, E., Bernady, P., Bertagna, Y., Biotti, D., Blanchard-Dauphin, A., Bonenfant, J., Bonnan, M., Bonnemain, B., Borgel, F., Botelho-Nevers, E., Boucly, S., Bourre, B., Boutière, C., Branger, P., Brassat, D., Bresch, S., Breuil, V., Brochet, B., Brugeilles, H., Bugnon, P., Cabre, P., Camdessanché, J.-P., Carra-Dalière, C., Casez, O., Chamouard, J.-M., Chassande, B., Chataignier, P., Chbicheb, M., Chenet, A., Ciron, J., Clavelou, P., Cohen, M., Colamarino, R., Collongues, N., Coman, I., Corail, P.-R., Courtois, S., Coustans, M., Creange, A., Creisson, E., Daluzeau, N., Davenas, C., De Seze, J., Debouverie, M., Depaz, R., Derache, N., Divio, L., Douay, X., Dulau, C., Durand-Dubief, F., Edan, G., Elias, Z., Fagniez, O., Faucher, M., Faucheux, J.-M., Fournier, M., Gagneux-Brunon, A., Gaida, P., Galli, P., Gallien, P., Gaudelus, J., Gault, D., Gayou, A., Genevray, M., Gentil, A., Gere, J., Gignoux, L., Giroux, M., Givron, P., Gout, O., Grimaud, J., Guennoc, A.-M., Hadhoum, N., Hautecoeur, P., Heinzlef, O., Jaeger, M., Jeannin, S., Kremer, L., Kwiatkowski, A., Labauge, P., Labeyrie, C., Lachaud, S., Laffont, I., Lanctin-Garcia, C., Lannoy, J., Lanotte, L., Laplaud, D., Latombe, D., Lauxerois, M., Le Page, E., Lebrun-Frenay, C., Lejeune, P., Lejoyeux, P., Lemonnier, B., Leray, E., Loche, C.-M., Louapre, C., Lubetzki, C., Maarouf, A., Mada, B., Magy, L., Maillart, E., Manchon, E., Marignier, R., Marque, P., Mathey, G., Maurousset, A., Mekies, C., Merienne, M., Michel, L., Milor, A.-M., Moisset, X., Montcuquet, A., Moreau, T., Morel, N., Moussa, M., Naudillon, J.-P., Normand, M., Olive, P., Ouallet, J.-C., Outteryck, O., Pacault, C., Papeix, C., Patry, I., Peaureaux, D., Pelletier, J., Pichon, B., Pittion, S., Planque, E., Pouget, M.-C., Pourcher, V., Radot, C., Robert, I., Rocher, F., Ruet, A., Saint-Val, C., Salle, J.-Y., Salmon, A., Sartori, E., Schaeffer, S., Stankhof, B., Taithe, F., Thouvenot, E., Tizon, C., Tourbah, A., Tourniaire, P., Vaillant, M., Vermersch, P., Vidil, S., Wahab, A., Warter, M.-H., Wiertlewski, S., Wiplosz, B., Wittwer, B., Zaenker, C., Zephir, H., Lebrun, C., and Vukusic, S.

Published
2019
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6. Efficacy and Safety of AbobotulinumtoxinA (Dysport) for the Treatment of Hemiparesis in Adults With Upper Limb Spasticity Previously Treated With Botulinum Toxin: Subanalysis From a Phase 3 Randomized Controlled Trial

Author

Ayyoub, Z., Banach, M., Bensmail, D., Bentivoglio, A.R., Boyer, F.C., Brashear, A., Csanyi, A., Deltombe, T., Denes, Z., Edgley, S., Gul, F., Gracies, J.-M., Hedera, P., Isaacson, S., Isner-Horobeti, M.-E., Jech, R., Kaminska, A., Khatkova, S., Kocer, S., Lejeune, T., McAllister, P., Marciniak, C., Marque, P., O’Dell, M., Remy-Neris, O., Rubin, B., Rudzinska-Bar, M., Simpson, D., Skoromets, A., Timerbaeva, S.L., Valkovic, P., Vecchio, M., Walker, H., Wimmer, M., Marciniak, Christina, McAllister, Peter, Walker, Heather, Brashear, Allison, Edgley, Steven, Deltombe, Thierry, Khatkova, Svetlana, Banach, Marta, Gul, Fatma, Vilain, Claire, Picaut, Philippe, Grandoulier, Anne-Sophie, and Gracies, Jean-Michel

Published
2017
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10. Infections and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

Papeix, C., primary, Donze, C., additional, Lebrun-Frénay, C., additional, Papeix, C., additional, Donzé, C., additional, Laplaud, D., additional, Thouvenot, E., additional, Ayrignac, X., additional, Pourcher-Martinez, V., additional, Zéphir, H., additional, de Seze, J., additional, Michel, L., additional, Bensa, C., additional, Cara-Dalliere, C., additional, Guen-noc, A.M., additional, Casez, O., additional, Maarouf, A., additional, Bourre, B., additional, Kwiatkowski, A., additional, Cohen, M., additional, Maillart, E., additional, Collongues, N., additional, Louapre, C., additional, Androdias, G., additional, Guegen, A., additional, Audoin, B., additional, Mattey, G., additional, Bernady, P., additional, Faucheux, J.M., additional, Labauge, P., additional, Meckies, C., additional, Stankoff, B., additional, Tourniaire, P., additional, Dinh, A., additional, Guennoc, A.M., additional, Durnad-Dubief, F., additional, Wiertlewski, S., additional, Derache, N., additional, Le page, E., additional, Pittion, S., additional, Vukusic, S., additional, Clavelou, P., additional, Heinzlef, O., additional, Colamarino, R., additional, Planque, E., additional, Rico, A., additional, Sheiber nogueira, C., additional, de Seze, M., additional, Ciron, J., additional, Alchaar, H., additional, Bensmail, D., additional, Biotti, D., additional, Branger, P., additional, Brochet, B., additional, Castan, B., additional, Creange, A., additional, Creisson, E., additional, DeBroucker, T., additional, Depaz, R., additional, Douay, X., additional, Dulau, C., additional, Faucher, M., additional, Fournier, M., additional, Fromont, A., additional, Gallien, P., additional, Gout, O., additional, Grimaud, J., additional, Hervé, Y., additional, Kerbrat, A., additional, Kremer, L., additional, Lanotte, L., additional, Magy, L., additional, Mania, A., additional, Maurousset, A., additional, Moisset, X., additional, Montcuquet, A., additional, Moreau, T., additional, Morel, N., additional, Patry, I., additional, Peaureaux, D., additional, Pouget, M.C., additional, Ruet, A., additional, Saint-Val, C., additional, Stahl, J.P., additional, Taithe, F., additional, Tattevin, P., additional, Vaillant, M., additional, and Vuoto, F., additional

Published
2021
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11. Drug treatments for spasticity

Author

Yelnik, A.P., Simon, O., Bensmail, D., Chaleat-Valayer, E., Decq, P., Dehail, P., Quentin, V., Marque, P., Parratte, B., Pellas, F., Rousseaux, M., Trocello, J.-M., Uzzan, M., and Dumarcet, N.

Published
2009
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18. A practical guide to optimizing the benefits of post-stroke spasticity interventions with botulinum toxin A: An international group consensus

Author

Francisco, G, primary, Balbert, A, additional, Bavikatte, G, additional, Bensmail, D, additional, Carda, S, additional, Deltombe, T, additional, Draulans, N, additional, Escaldi, S, additional, Gross, R, additional, Jacinto, J, additional, Ketchum, N, additional, Molteni, F, additional, Perez, S, additional, O’Dell, M, additional, Reebye, R, additional, Säterö, P, additional, Verduzco-Gutierrez, M, additional, Walker, H, additional, and Wissel, J, additional

Published
2021
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25. Efficacy and Safety of AbobotulinumtoxinA (Dysport) for the Treatment of Hemiparesis in Adults With Upper Limb Spasticity Previously Treated With Botulinum Toxin: Subanalysis From a Phase 3 Randomized Controlled Trial

Author

Marciniak, Christina, Mcallister, Peter, Walker, Heather, Brashear, Allison, Edgley, Steven, Deltombe, Thierry, Khatkova, Svetlana, Banach, Marta, Gul, Fatma, Vilain, Claire, Picaut, Philippe, Grandoulier, Anne-Sophie, Gracies, Jean-Michel, Ayyoub, Z., Banach, M., Bensmail, D., Bentivoglio, A. R., Boyer, F. C., Brashear, A., Csanyi, A., Deltombe, T., Denes, Z., Edgley, S., Gul, F., Gracies, J. -M., Hedera, P., Isaacson, S., Isner-Horobeti, M. -E., Jech, R., Kaminska, A., Khatkova, S., Kocer, S., Lejeune, T., Mcallister, P., Marciniak, C., Marque, P., O'Dell, M., Remy-Neris, O., Rubin, B., Rudzinska-Bar, M., Simpson, D., Skoromets, A., Timerbaeva, S. L., Valkovic, P., Vecchio, M., Walker, H., Wimmer, M., UCL - (MGD) Service de médecine physique et revalidation, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de médecine physique et de réadaptation motrice, and UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab

Subjects
Male, 030506 rehabilitation, Physical Therapy, Acetylcholine Release Inhibitors, law.invention, 0302 clinical medicine, Randomized controlled trial, Physical Therapy, Sports Therapy and Rehabilitation, Rehabilitation, Neurology, Neurology (clinical), law, Prospective Studies, Botulinum Toxins, Type A, Aged, 80 and over, education.field_of_study, Middle Aged, Botulinum toxin, Paresis, Settore MED/26 - NEUROLOGIA, Treatment Outcome, medicine.anatomical_structure, Neuromuscular Agents, Muscle Spasticity, Female, medicine.symptom, 0305 other medical science, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Modified Ashworth scale, Population, Sports Therapy and Rehabilitation, Placebo, Injections, Intramuscular, Upper Extremity, Young Adult, 03 medical and health sciences, Muscle tone, Double-Blind Method, medicine, Humans, Spasticity, education, Aged, business.industry, Hemiparesis, Physical therapy, business, 030217 neurology & neurosurgery
Abstract

Objective To assess the efficacy and safety of abobotulinumtoxinA in adults with upper limb spasticity previously treated with botulinum toxin A (BoNT-A). Design A post hoc analysis from a Phase 3, prospective, double-blind, randomized, placebo-controlled study (NCT01313299). Setting A total of 34 neurology or rehabilitation clinics in 9 countries. Participants Adults aged 18-80 years with hemiparesis, ≥6 months after stroke or traumatic brain injury. This analysis focused on a subgroup of subjects with previous onabotulinumtoxinA or incobotulinumtoxinA treatment (n = 105 of 243 in the total trial population) in the affected limb. The mean age was 52 years, and 62% were male. Intervention Study subjects were randomized 1:1:1 to receive a single injection session with abobotulinumtoxinA 500 or 1000 U or with placebo in the most hypertonic muscle group among the elbow, wrist, or finger flexors (primary target muscle group [PTMG]), and ≥2 additional muscle groups from the upper limb. Main Outcome Measurements Efficacy and safety measures were assessed, including muscle tone (Modified Ashworth Scale [MAS] in the PTMG), Physician Global Assessment (PGA), perceived function, spasticity, active movement, and treatment-emergent adverse events. Results At week 4, more subjects had ≥1 grade improvement in MAS for the PTMG with abobotulinumtoxinA versus placebo (abobotulinumtoxinA 500 U, 81.1%; abobotulinumtoxinA 1000 U, 75.0%; placebo, 25.0%). PGA scores ≥1 were achieved by 75.7% and 87.5% of abobotulinumtoxinA 500 and 1000 U subjects versus 41.7% with placebo. Perceived function (Disability Assessment Scale), spasticity angle (Tardieu Scale), and active movement were also improved with abobotulinumtoxinA. There were no treatment-related deaths or serious adverse events. Conclusions The efficacy and safety of abobotulinumtoxinA in subjects previously treated with BoNT-A were consistent with those in the total trial population. Hence, abobotulinumtoxinA is a treatment option in these patients, and no difference in initial dosing appears to be required compared to that in individuals not treated previously. Level of Evidence III

Published
2017

28. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

Lebrun, C., primary, Vukusic, S., additional, Abadie, V., additional, Achour, C., additional, Ader, F., additional, Alchaar, H., additional, Alkhedr, A., additional, Andreux, F., additional, Androdias, G., additional, Arjmand, R., additional, Audoin, B., additional, Audry, D., additional, Aufauvre, D., additional, Autreaux, C., additional, Ayrignac, X., additional, Bailbe, M., additional, Benazet, M., additional, Bensa, C., additional, Bensmail, D., additional, Berger, E., additional, Bernady, P., additional, Bertagna, Y., additional, Biotti, D., additional, Blanchard-Dauphin, A., additional, Bonenfant, J., additional, Bonnan, M., additional, Bonnemain, B., additional, Borgel, F., additional, Botelho-Nevers, E., additional, Boucly, S., additional, Bourre, B., additional, Boutière, C., additional, Branger, P., additional, Brassat, D., additional, Bresch, S., additional, Breuil, V., additional, Brochet, B., additional, Brugeilles, H., additional, Bugnon, P., additional, Cabre, P., additional, Camdessanché, J.-P., additional, Carra-Dalière, C., additional, Casez, O., additional, Chamouard, J.-M., additional, Chassande, B., additional, Chataignier, P., additional, Chbicheb, M., additional, Chenet, A., additional, Ciron, J., additional, Clavelou, P., additional, Cohen, M., additional, Colamarino, R., additional, Collongues, N., additional, Coman, I., additional, Corail, P.-R., additional, Courtois, S., additional, Coustans, M., additional, Creange, A., additional, Creisson, E., additional, Daluzeau, N., additional, Davenas, C., additional, De Seze, J., additional, Debouverie, M., additional, Depaz, R., additional, Derache, N., additional, Divio, L., additional, Douay, X., additional, Dulau, C., additional, Durand-Dubief, F., additional, Edan, G., additional, Elias, Z., additional, Fagniez, O., additional, Faucher, M., additional, Faucheux, J.-M., additional, Fournier, M., additional, Gagneux-Brunon, A., additional, Gaida, P., additional, Galli, P., additional, Gallien, P., additional, Gaudelus, J., additional, Gault, D., additional, Gayou, A., additional, Genevray, M., additional, Gentil, A., additional, Gere, J., additional, Gignoux, L., additional, Giroux, M., additional, Givron, P., additional, Gout, O., additional, Grimaud, J., additional, Guennoc, A.-M., additional, Hadhoum, N., additional, Hautecoeur, P., additional, Heinzlef, O., additional, Jaeger, M., additional, Jeannin, S., additional, Kremer, L., additional, Kwiatkowski, A., additional, Labauge, P., additional, Labeyrie, C., additional, Lachaud, S., additional, Laffont, I., additional, Lanctin-Garcia, C., additional, Lannoy, J., additional, Lanotte, L., additional, Laplaud, D., additional, Latombe, D., additional, Lauxerois, M., additional, Le Page, E., additional, Lebrun-Frenay, C., additional, Lejeune, P., additional, Lejoyeux, P., additional, Lemonnier, B., additional, Leray, E., additional, Loche, C.-M., additional, Louapre, C., additional, Lubetzki, C., additional, Maarouf, A., additional, Mada, B., additional, Magy, L., additional, Maillart, E., additional, Manchon, E., additional, Marignier, R., additional, Marque, P., additional, Mathey, G., additional, Maurousset, A., additional, Mekies, C., additional, Merienne, M., additional, Michel, L., additional, Milor, A.-M., additional, Moisset, X., additional, Montcuquet, A., additional, Moreau, T., additional, Morel, N., additional, Moussa, M., additional, Naudillon, J.-P., additional, Normand, M., additional, Olive, P., additional, Ouallet, J.-C., additional, Outteryck, O., additional, Pacault, C., additional, Papeix, C., additional, Patry, I., additional, Peaureaux, D., additional, Pelletier, J., additional, Pichon, B., additional, Pittion, S., additional, Planque, E., additional, Pouget, M.-C., additional, Pourcher, V., additional, Radot, C., additional, Robert, I., additional, Rocher, F., additional, Ruet, A., additional, Saint-Val, C., additional, Salle, J.-Y., additional, Salmon, A., additional, Sartori, E., additional, Schaeffer, S., additional, Stankhof, B., additional, Taithe, F., additional, Thouvenot, E., additional, Tizon, C., additional, Tourbah, A., additional, Tourniaire, P., additional, Vaillant, M., additional, Vermersch, P., additional, Vidil, S., additional, Wahab, A., additional, Warter, M.-H., additional, Wiertlewski, S., additional, Wiplosz, B., additional, Wittwer, B., additional, Zaenker, C., additional, and Zephir, H., additional

Published
2019
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35. Rehabilitation robotics of the upper limb after stroke. The REM_AVC trial

Author

Rémy-Néris, O., primary, Médée, B., additional, Bensmail, D., additional, Daveluy, W., additional, Benaim, C., additional, Froger, J., additional, Bonan, I., additional, Marque, P., additional, Luaute, J., additional, Ferrapie, A.L., additional, Yelnik, A., additional, Stefan, A., additional, Daviet, J.C., additional, Coudeyre, E., additional, Beis, J.M., additional, Kerdraon, J., additional, Isambert, J.L., additional, and Dehail, P., additional

Published
2018
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45. Safety and efficacy of abobotulinumtoxinA for hemiparesis in adults with upper limb spasticity after stroke or traumatic brain injury : a double-blind randomised controlled trial

Author

Gracies, J, Brashear, A, Jech, R, Mcallister, P, Banach, M, Valkovic, P, Walker, H, Marciniak, C, Deltombe, T, Skoromets, A, Khatkova, S, Edgley, S, Gul, F, Catus, F, De Fer, Bb, Vilain, C, Picaut, P, Ayyoub, Z, Bensmail, D, Bentivoglio, Anna Rita, Boyer, F, Csanyi, A, Denes, Z, Gracies, Jm, Hedera, P, Isaacson, S, Isner Horobeti, Me, Kaminska, A, Kocer, S, Lejeune, T, Marque, P, O'Dell, M, Remy Neris, O, Rubin, B, Rudzinska, M, Simpson, D, Timerbaeva, Sl, Vecchio, M, and Wimmer, M.

Subjects
Adult, Male, medicine.medical_specialty, Botulinum Toxins, Modified Ashworth scale, Acetylcholine Release Inhibitors, Placebo, Injections, Intramuscular, law.invention, Type A, Injections, Upper Extremity, Muscle tone, Randomized controlled trial, Double-Blind Method, law, Spastic, medicine, Humans, Spasticity, Botulinum Toxins, Type A, Intramuscular, Intention-to-treat analysis, business.industry, Middle Aged, Paresis, Stroke, Settore MED/26 - NEUROLOGIA, medicine.anatomical_structure, Hemiparesis, Treatment Outcome, Muscle Spasticity, Anesthesia, Brain Injuries, Physical therapy, Female, Neurology (clinical), medicine.symptom, business
Abstract

Summary Background Resistance from antagonistic muscle groups might be a crucial factor reducing function in chronic hemiparesis. The resistance due to spastic co-contraction might be reduced by botulinum toxin injections. We assessed the effects of abobotulinumtoxinA injection in the upper limb muscles on muscle tone, spasticity, active movement, and function. Methods In this randomised, placebo-controlled, double-blind study, we enrolled adults (aged 18–80 years) at least 6 months after stroke or brain trauma from 34 neurology or rehabilitation clinics in Europe and the USA. Eligible participants were randomly allocated in a 1:1:1 ratio with a computer-generated list to receive a single injection session of abobotulinumtoxinA 500 U or 1000 U or placebo into the most hypertonic muscle group among the elbow, wrist, or finger flexors (primary target muscle group [PTMG]), and into at least two additional muscle groups from the elbow, wrist, or finger flexors or shoulder extensors. Patients and investigators were masked to treatment allocation. The primary endpoint was the change in muscle tone (Modified Ashworth Scale [MAS]) in the PTMG from baseline to 4 weeks. Secondary endpoints were Physician Global Assessment (PGA) at week 4 and change from baseline to 4 weeks in the perceived function (Disability Assessment Scale [DAS]) in the principal target of treatment, selected by the patient together with physician from four functional domains (dressing, hygiene, limb position, and pain). Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT01313299. Findings 243 patients were randomly allocated to placebo (n=81), abobotulinumtoxinA 500 U (n=81), or abobotulinumtoxinA 1000 U (n=81). Mean change in MAS score from baseline at week 4 in the PTMG was −0·3 (SD 0·6) in the placebo group (n=79), −1·2 (1·0) in the abobotulinumtoxinA 500 U group (n=80; difference −0·9, 95% CI −1·2 to −0·6; p vs placebo), and −1·4 (1·1) in the abobotulinumtoxinA 1000 U group (n=79; −1·1, −1·4 to −0·8; p vs placebo). Mean PGA score at week 4 was 0·6 (SD 1·0) in the placebo group (n=78), 1·4 (1·1) in the abobotulinumtoxinA 500 U group (n=80; p=0·0003 vs placebo), and 1·8 (1·1) in the abobotulinumtoxinA 1000 U group (n=78; p vs placebo). Mean change from baseline at week 4 in DAS score for the principal target of treatment was −0·5 (0·7) in the placebo group (n=79), −0·7 (0·8) in the abobotulinumtoxinA 500 U group (n=80; p=0·2560 vs placebo), and −0·7 (0·7) in the abobotulinumtoxinA 1000 U group (n=78; p=0·0772 vs placebo). Three serious adverse events occurred in each group and none were treatment related; two resulted in death (from pulmonary oedema in the placebo group and a pre-existing unspecified cardiovascular disorder in the abobotulinumtoxinA 500 U group). Adverse events that were thought to be treatment related occurred in two (2%), six (7%), and seven (9%) patients in the placebo, abobotulinumtoxinA 500 U, and abobotulinumtoxinA 1000 U groups, respectively. The most common treatment-related adverse event was mild muscle weakness. All adverse events were mild or moderate. Interpretation AbobotulinumtoxinA at doses of 500 U or 1000 U injected into upper limb muscles provided tone reduction and clinical benefit in hemiparesis. Future research into the treatment of spastic paresis with botulinum toxin should use active movement and function as primary outcome measures. Funding Ipsen.

Published
2015

46. Isokinetic assessment of the effects of botulinum toxin injection on spasticity and voluntary strength in patients with spastic hemiparesis

Author

Hameau, S., Bensmail, D, Robertson, J, Boudarham, J, Roche, N., Zory, R., Institut des Nanosciences de Paris (INSP), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre Spatial Universitaire de Montpellier-Nîmes (CSU), Université de Montpellier (UM), Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université de Toulon (UTLN)-Université Côte d'Azur (UCA), and zory, raphael

Subjects
musculoskeletal diseases, Adult, Male, Knee Joint, [SDV]Life Sciences [q-bio], Acetylcholine Release Inhibitors, Muscle Strength Dynamometer, Injections, Intramuscular, Quadriceps Muscle, Humans, Muscle Strength, Botulinum Toxins, Type A, Range of Motion, Articular, Gait, Aged, Recovery of Function, Middle Aged, musculoskeletal system, [SDV] Life Sciences [q-bio], body regions, Paresis, Stroke, Treatment Outcome, Muscle Spasticity, Chronic Disease, Female, human activities
Abstract

Peak knee flexion during swing phase is frequently reduced following stroke. The main treatment is botulinum toxin injection (BoNT-A) of the Rectus Femoris (RF) muscle. BoNT-A injections have been shown to decrease spasticity (assessed using the modified Ashworth scale) and to improve peak knee flexion during swing phase. Although the effect of BoNT-A has been clearly demonstrated on kinematic parameters during gait, the direct effects on spasticity and strength have been little studied using objective and sensitive outcome measures.The aim of this study was to use an isokinetic dynamometer to assess the effects of BoNT-A injection in the RF on stretch reflex-related torque at the knee joint and peak voluntary knee flexor and extensor torque and to evaluate the effect on functional capacity.Before-after trial: Assessments were carried out pre and post (four weeks) RF BoNT-A injection. Clinical and isokinetic evaluations were carried out.Ambulatory care in a hospital setting. Participants. Population-based sample of fourteen chronic spastic hemiparetic patients with stiff knee gait.Primary outcome measurements were stretch reflex-related torque at the knee joint and peak voluntary knee flexor and extensor torque. Secondary outcomes were knee angle at peak torque, the slope of the torque velocity curve, stiffness and functional outcomes.Peak knee extensor torque was significantly decreased and peak knee flexor torque was significantly increased during maximal voluntary concentric and isometric contractions following BoNT-A injection of the RF. Stretch reflex-related torque evaluated during passive stretching movements was reduced and the angle of occurrence of the peak was greater. Functional outcomes did not change. CONCLUSIONS AND CLINICAL REHABILITATION IMPACT: The results of this study indicate that BoNT-A injection reduced RF spasticity but also reduced quadriceps strength. In contrast, knee flexor strength increased. These changes did not, however, lead to functional gait changes.

Published
2014

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