scholarly journals Emerging Concepts and Evidence in Telematics Novel Approaches or Treatments for Spasticity Management After Botulinum Injection

2021 ◽  
Vol 2 ◽  
Author(s):  
Helena Bascuñana-Ambrós ◽  
Mª Josep Nadal-Castells ◽  
Eliot Ramírez-Mirabal ◽  
Marta Beranuy-Rodriguez ◽  
Alberto Pintor-Ojeda ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Botulinum Toxin ◽  
Therapeutic Target ◽  
Physical Therapists ◽  
Botulinum Toxin Injection ◽  
Real Life ◽  
Strong Recommendation ◽  
Therapist Adherence ◽  
Novel Approaches

There is a strong recommendation for the use of intramuscular botulinum toxin in patients with persistent or progressive spasticity affecting one or more joints and who have an identifiable therapeutic target. After a botulinum toxin injection, a stretching intervention improves the results of the treatment, and it should be performed by patients and/or caregivers after being trained by a therapist. Adherence to this recommendation remains low once the therapist stops following the patient. The COVID-19 pandemic has increased the use of telemedicine with different approaches to treat patients. There has been an increased use of motivational applications, with virtual reality software and real-life videos, which provide a gaming experience that increases adherence. There are programs with synchronous telehealth exercises guided by physical therapists or software with sensor-based technology that shows the range of motion (ROM) and strength of the muscles of a particular joint. These new approaches to patient follow-up appear to increase adherence to exercise because they need to be “watched and controlled” is achieved.

scholarly journals Botulinum Toxin Injection with Conjunctival Microincision for the Treatment of Acute Acquired Comitant Esotropia and Its Effectiveness

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hongjia Xu ◽  
Weifeng Sun ◽  
Shuying Dai ◽  
Yanyan Cheng ◽  
Jing Zhao ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Binocular Vision ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Injection ◽  
Age At Onset ◽  
Brain Magnetic Resonance Imaging ◽  
Significant Difference ◽  
Angle Of Deviation ◽  
The Mean

Purpose. To report on an improved botulinum toxin injection with conjunctival microincision for beginners, and to determine the effectiveness of botulinum toxin A (BTXA) in the treatment of patients with acute acquired comitant esotropia (AACE). Methods. Medical records of 29 AACE patients were retrospectively analyzed. BTXA was injected into the unilateral or bilateral medial rectus muscle with conjunctival microincision without electromyographic guidance. Success was defined as total horizontal deviation ≤10 prism diopters (PD) and evidence of binocular vision. Results. Twenty-nine patients were included, of whom 22 were male and 7 were female. The mean age at onset was 14.2 ± 7.4 (range, 4–34) years. The mean time from onset of AACE to injection was 18.4 ± 20.3 (range, 1–96) weeks. All patients completed at least 6 months of follow-up, and the mean follow-up after BTXA injection was 12.3 ± 4.8 months (range, 7–24 months). Neurological evaluation and brain magnetic resonance imaging (MRI) were unremarkable in all patients. The mean spherical equivalent refraction was −1.22 ± 2.85D and −0.97 ± 2.80D in the right and left eyes, respectively. Mean preinjective esotropia was 38.4 ± 18.9 PD (range, +10–+80 PD) at near and 40.2 ± 17.7 PD (range, +20–+80 PD) at far distance. The mean angle of deviation at 6 months after injection was 0.6 ± 4.1 PD (range, −3–+15 PD) at near and 3.0 ± 5.9 PD (range, 0–+20 PD) at far distance. There was significant difference in the angle of deviation at near and far fixation between pre-BTXA and post-BTXA 6 months ( p < 0.001 , p < 0.001 , resp.). There was no significant difference in the angle of deviation at near and far fixation between post-BTXA 6 months and post-BTXA at final follow-up ( p  = 0.259 and 0.326, resp.). Mean stereoacuity improved from 338 to 88 arc seconds. During the follow-up period, 5 of 29 patients had recurrent esotropia. Two patients refused all further treatment, and the other 3 patients required incisional strabismus surgery. The success rates were 86.2% (25/29) at 6 months and 82.8% (24/29) at final follow-up. Conclusion. Conjunctival microincision injection of botulinum toxin is a practical and safe method for beginners to locate an extraocular muscle, which is as effective as the traditional methods. Botulinum toxin injection can be preferred as the first-line treatment for AACE patients with potential binocular vision.

Pharmacotherapy failure and progression to botulinum toxin injection in vestibular migraine

2020 ◽  
Vol 134 (7) ◽  
pp. 586-591
Author(s):  
Y F Liu ◽  
D Macias ◽  
L Donaldson ◽  
J R Dornhoffer ◽  
H G Rizk
Keyword(s):  
Botulinum Toxin ◽  
Retrospective Cohort ◽  
Botulinum Toxin Injection ◽  
Vestibular Migraine ◽  
Aggressive Treatment ◽  
Dizziness Handicap Inventory ◽  
Factors Associated ◽  
The Mean ◽  
Pre Treatment

AbstractObjectiveGiven the lack of evidence on patients with medically refractory vestibular migraine, this study aimed to identify factors associated with pharmacotherapy failure and progression to botulinum toxin injection in vestibular migraine.MethodsA retrospective cohort study was conducted on definite vestibular migraine patients from September 2015 to July 2019 who completed the Dizziness Handicap Inventory at least six weeks apart..ResultsThe study comprised 47 patients (mean age = 50.2 ± 15.8 years), with a mean follow-up time of 6.0 ± 6.0 months. The mean pre-treatment Dizziness Handicap Inventory score was 57.5 ± 23.5, with a mean reduction of 17.3 ± 25.2 (p < 0.001) at last follow up. Oscillopsia (r = 0.458, p = 0.007), failure of first medication (r = 0.518, p = 0.001) and pre-treatment Dizziness Handicap Inventory question 15 (an emotional domain question) score (r = 0.364, p = 0.019) were the only variables significantly correlated with progression to botulinum toxin injection.ConclusionMotion hypersensitivity, failure of first medication, and fear of social stigmatisation suggest a decreased treatment response. These symptoms may require more aggressive treatment at an earlier stage.

A new therapeutic target in equinus: Botulinum toxin injection (Dysport®) in peroneus longus

2013 ◽  
Vol 38 ◽  
pp. S51-S52
Author(s):  
Christophe Boulay ◽  
Michel Jacquemier ◽  
Vincent Pomero ◽  
Yann Glard ◽  
Elisabeth Castanier ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Therapeutic Target ◽  
Botulinum Toxin Injection ◽  
Peroneus Longus

Mandibular Rim Trilogy with Botulinum Toxin Injection: Reduction, Projection, and Lift

2017 ◽  
Vol 33 (01) ◽  
pp. 102-108 ◽  
Author(s):  
Renpeng Zhou ◽  
Benyun Pan ◽  
Chen Wang ◽  
Danru Wang
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Injection ◽  
Facial Rejuvenation ◽  
Lower Face ◽  
Young Females ◽  
Facial Contour ◽  
Facial Identity ◽  
Asian Patients ◽  
The Aesthetic

Abstract“Onabotulinum toxin A (Botox) revolution” has brought the fundamental change in the facial rejuvenation as well as the concept of microinjection. The aesthetic standard tends to be the “globalization”; however, Asians have different aesthetic cultures and unique facial features compared with Caucasians. A new rejuvenation concept is proposed during our practice; the Asian face should preserve the original facial identity during Botox treatments. The lower face is treated with botulinum toxin to achieve a harmonious facial profile. Twenty young females ranging in age from 30 to 45 years consented and received the three-pronged procedure from March 2014 to April 2015; photography at baseline and follow-up visit were taken and analyzed. After posttreatment for 2 months, significant improvement was observed compared with the baseline. And the reduced masseter prominence and prominent chin were obtained, showing a favorable facial contour and harmonious appearance during the follow-up. The novel three-pronged approach to lower facial rejuvenation was aimed at the Asian characteristic of hypertrophic masseter, chin retrusion, and the facial sagging during the aging process. Botox treatment was a quite effective and safe strategy to improve the appearance and contour of the lower face in Asian patients.

Treatment of Achalasia: Botulinum Toxin Injection vs. Pneumatic Balloon Dilation. A Prospective Study with Long-Term Follow-Up

Endoscopy ◽  
2001 ◽  
Vol 33 (12) ◽  
pp. 1007-1017 ◽  
Author(s):  
H. D. Allescher ◽  
M. Storr ◽  
M. Seige ◽  
R. Gonzales-Donoso ◽  
R. Ott ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Prospective Study ◽  
Botulinum Toxin Injection ◽  
Balloon Dilation ◽  
Long Term Follow Up ◽  
Pneumatic Balloon Dilation ◽  
A Prospective Study

A COMPARATIVE STUDY BETWEEN EFFICACIES OF USG GUIDED BOTULINUM TOXIN INJECTION INTO THE SUBSCAPULARIS MUSCLE AND THE CONSERVATIVE TREATMENT IN HEMIPLEGIC SHOULDER PAIN

2021 ◽  
pp. 16-20
Author(s):  
Subhadeep Batabyal ◽  
Saumen Kumar De ◽  
Rathindra Nath Haldar
Keyword(s):  
Botulinum Toxin ◽  
Conservative Treatment ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
External Rotation ◽  
Botulinum Toxin Injection ◽  
Subscapularis Muscle ◽  
Group 2 ◽  
Group 1

Introduction: Hemiplegic shoulder pain (HSP) is a common complication after stroke. HSP inhibits recovery and rehabilitation and impairs the quality of life of stroke survivors. Although the etiology of HSP is not well known, it has been suggested that multiple factors contribute to HSP. Our approach is to compare the efcacy of USG guided Botulinum toxin injection into the subscapularis muscle and conservative treatment in case of intractable hemiplegic shoulder pain. Material and methods: In this Parallel Group Open Level Randomized Controlled Trial, conducted in the Department of Physical Medicine and Rehabilitation, IPGME&R, SSKM Hospital, Kolkata between September, 2017 to September, 2018 (Twelve months) on 34 (17 in each group) patients with intractable (persistent pain for more than 3 months) hemiplegic shoulder pain. In group 1, Botulinum toxin injection was given in subscapularis muscle by USG guided lateral approach. In group 2, managed conservatively with Physical therapy (stretching, passive range of motion exercise), Modality (hot pack, infrared, IFT), pain medications (NSAIDS, oral opioids) and Neuromuscular electrical stimulation of shoulder. Parameters used: 1. Pain intensity - measured by Numerical Rating Scale (NRS) [Score 0- 10], 2. Spasticity measured by - Modied Ashworth Scale (MAS) [score 0-4], 3. Shoulder range of motion - External rotation (ER) [score 0- 90] assessed. The patients attending the Physical Medicine and Rehabilitation OPD at IPGME&R and SSKM Hospital, Kolkata were included and studied if they fullled the inclusion and nd exclusion criteria after getting Institutional Ethics Committee clearance and informed written consent. After initial visit, followed up on 2 week, th th 4 week and 12 week. Comparison done considering all the parameters considering basal and follow up data to compare the efcacy of intramuscular botulinum toxin injection and those with in group 2, managed conservatively. Results: All the data collected during this study period were analyzed by using statistical software Statistica vertsion 6 [Tulsa, Oklahoma: StatSoft Inc., 2001] and GraphPad Prism version 4 [San Diego, California: GraphPad Software Inc., 2005]. There was statistically signicant difference (group 1 is statistically superior than group 2) between two groups at 2nd, 4th and 12th week in respect to NRS, MAS of subscapularis and ER of shoulder joint (p value<0.05). Conclusion: There was signicant short-term improvement of shoulder pain, spasticity of shoulder internal rotator(subscapularis) and range of motion in the form of external rotation after Botulinum toxin injection compared to conservative treatment. But in terms of intermediate-term and long-term follow-up although both groups showed signicant improvement but Botulinum toxin injection group was statistically superior than conservative treatment.

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