Overview of botulinum toxin as a treatment for spasticity in stroke patients

Abstract

Spasticity after the occurrence of stroke induces limb deformity, functional disability and/or pain in patients, which limits their activities of daily living and deteriorates their quality of life. Botulinum toxin (BTX) has recently been reported as an efficacious therapeutic agent for the treatment of spasticity. Systematic review and meta-analysis studies have demonstrated that BTX therapy after stroke reduces spasticity and increases physical activity capacity and performance levels. Moreover, BTX can be used as an adjuvant in physiotherapy. Several studies have confirmed that the combination of BTX therapy and physiotherapy improves motor recovery. However, to date, only a few such combination studies have been conducted and their findings are considered preliminary and controversial. Therefore, future studies are required to determine the appropriate combination of treatment methods that will aid motor recovery.

Keywords: Botulinum toxin, Rehabilitation, Stroke, Spasticity, Neurorehabilitation

Core tip: In this overview, we describe that botulinum toxins (BTXs) were very useful to reduce spasticity in stroke patients. Moreover, we introduce studies on appropriate effective and safe injection methods; pilot studies that evaluated combined rehabilitation and BTX treatment; and adverse events after BTX injection, including risk factors of neutralizing antibodies.