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Effects on walking of simultaneous upper/lower limb abobotulinumtoxina injections in patients with stroke or brain injury with spastic hemiparesis.

Abstract

OBJECTIVE

To compare walking speed in patients with spastic hemiparesis who received abobotulinumtoxinA either in the lower limb or simultaneously in both the lower and upper limbs.

DESIGN

Post hoc analysis from a phase 3 study of abobotulinumtoxinA (Dysport®, NCT01251367).

PATIENTS

Adult patients with spastic hemiparesis causing gait dysfunction.

METHODS

Comfortable barefoot walking speed over 10 m was evaluated in patients receiving lower limb vs lower and upper limb injections over ≤4 treatment cycles; 1,000 U or 1,500 U in lower limb for cycle 1/2; optional upper limb injections from cycle 3 (500 U: upper limb, 1,000 U: lower limb).

RESULTS

Mean (standard deviation; SD) lower limb cycle 3/4 doses were lower in the lower plus upper limb group vs lower limb only (1,000 U (SD 50), 1,000 U (SD 50) vs 1,380 U (SD 210), 1,360 U (SD 220). Baseline comfortable barefoot walking speed was similar between groups. Changes at cycle 3 week 4, in m/s, were: lower and upper limb: +0.063 (SD 0.131); lower limb only: +0.078 (SD 0.114), and cycle 4 week 4: lower and upper limb: +0.086 (SD 0.166); lower limb only: +0.086 (SD 0.123).

CONCLUSION

Simultaneous lower and upper limb abobotulinumtoxinA treatment does not hamper improvement in walking speed compared with lower limb treatment alone. Thus, physicians may split the 1,500 U abobotulinumtoxinA dose as needed to best treat patients with spastic paresis.

Authors+Show Affiliations

New England Institute for Neurology and Headach, , 06905 Stamford, USA. peter@neinh.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31529136

Citation

McAllister, Peter J., et al. "Effects On Walking of Simultaneous Upper/lower Limb Abobotulinumtoxina Injections in Patients With Stroke or Brain Injury With Spastic Hemiparesis." Journal of Rehabilitation Medicine, 2019.
McAllister PJ, Khatkova SE, Faux SG, et al. Effects on walking of simultaneous upper/lower limb abobotulinumtoxina injections in patients with stroke or brain injury with spastic hemiparesis. J Rehabil Med. 2019.
McAllister, P. J., Khatkova, S. E., Faux, S. G., Picaut, P., Raymond, R., & Gracies, J. M. (2019). Effects on walking of simultaneous upper/lower limb abobotulinumtoxina injections in patients with stroke or brain injury with spastic hemiparesis. Journal of Rehabilitation Medicine, doi:10.2340/16501977-2604.
McAllister PJ, et al. Effects On Walking of Simultaneous Upper/lower Limb Abobotulinumtoxina Injections in Patients With Stroke or Brain Injury With Spastic Hemiparesis. J Rehabil Med. 2019 Sep 17; PubMed PMID: 31529136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects on walking of simultaneous upper/lower limb abobotulinumtoxina injections in patients with stroke or brain injury with spastic hemiparesis. AU - McAllister,Peter J, AU - Khatkova,Svetlana E, AU - Faux,Steven G, AU - Picaut,Philippe, AU - Raymond,Romain, AU - Gracies,Jean-Michel, Y1 - 2019/09/17/ PY - 2019/9/19/entrez KW - botulinum toxin, type A KW - paresis KW - walking speed, stroke, traumatic brain injury KW - muscle spasticity JF - Journal of rehabilitation medicine JO - J Rehabil Med N2 - OBJECTIVE: To compare walking speed in patients with spastic hemiparesis who received abobotulinumtoxinA either in the lower limb or simultaneously in both the lower and upper limbs. DESIGN: Post hoc analysis from a phase 3 study of abobotulinumtoxinA (Dysport®, NCT01251367). PATIENTS: Adult patients with spastic hemiparesis causing gait dysfunction. METHODS: Comfortable barefoot walking speed over 10 m was evaluated in patients receiving lower limb vs lower and upper limb injections over ≤4 treatment cycles; 1,000 U or 1,500 U in lower limb for cycle 1/2; optional upper limb injections from cycle 3 (500 U: upper limb, 1,000 U: lower limb). RESULTS: Mean (standard deviation; SD) lower limb cycle 3/4 doses were lower in the lower plus upper limb group vs lower limb only (1,000 U (SD 50), 1,000 U (SD 50) vs 1,380 U (SD 210), 1,360 U (SD 220). Baseline comfortable barefoot walking speed was similar between groups. Changes at cycle 3 week 4, in m/s, were: lower and upper limb: +0.063 (SD 0.131); lower limb only: +0.078 (SD 0.114), and cycle 4 week 4: lower and upper limb: +0.086 (SD 0.166); lower limb only: +0.086 (SD 0.123). CONCLUSION: Simultaneous lower and upper limb abobotulinumtoxinA treatment does not hamper improvement in walking speed compared with lower limb treatment alone. Thus, physicians may split the 1,500 U abobotulinumtoxinA dose as needed to best treat patients with spastic paresis. SN - 1651-2081 UR - https://www.unboundmedicine.com/medline/citation/31529136/Effects_on_walking_of_simultaneous_upper/lower_limb_abobotulinumtoxina_injections_in_patients_with_stroke_or_brain_injury_with_spastic_hemiparesis L2 - https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-2604 DB - PRIME DP - Unbound Medicine ER -