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Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function

1
Department of Rehabilitation Medicine The Jikei University School of Medicine 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo 105-8461, Japan
2
Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa 213-8507, Japan
3
Rehabilitation Center, Ainomiyako Neurosurgery Hospital, Osaka 538-0044, Japan
*
Author to whom correspondence should be addressed.
Toxins 2019, 11(12), 707; https://doi.org/10.3390/toxins11120707
Received: 11 October 2019 / Revised: 29 November 2019 / Accepted: 3 December 2019 / Published: 5 December 2019
Aim: The purpose of this study was to examine the effectiveness of botulinum toxin A (BoNT-A) therapy combined with rehabilitation on motor function in post-stroke patients. Methods: The following sources up to December 31, 2018, were searched from inception for articles in English: Pubmed, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL. Trials using injections of BoNT-A for upper and lower limb rehabilitation were examined. We excluded studies that were not performed for rehabilitation or were not evaluated for motor function. Results: Twenty-six studies were included. In addition to rehabilitation, nine studies used adjuvant treatment to improve spasticity or improve motor function. In the upper limbs, two of 14 articles indicated that significant improvement in upper limb motor function was observed compared to the control group. In the lower limbs, seven of 14 articles indicated that significant improvement in lower limb motor function was observed compared to the control group. Conclusions: The effect of combined with rehabilitation is limited after stroke, and there is not sufficient evidence, but results suggest that BoNT-A may help to improve motor function. In future studies, the establishment of optimal rehabilitation and evaluation times of BoNT-A treatment will be necessary for improving motor function and spasticity. View Full-Text
Keywords: stroke; botulinum toxin; spasticity; rehabilitation; upper limbs; lower limbs; motor function stroke; botulinum toxin; spasticity; rehabilitation; upper limbs; lower limbs; motor function
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Hara, T.; Momosaki, R.; Niimi, M.; Yamada, N.; Hara, H.; Abo, M. Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function. Toxins 2019, 11, 707.

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