| Investigating muscle selection for botulinum toxin-A injections in adults with post-stroke upper limb spasticity. | |
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MedLine Citation:
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PMID: 22031350 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Limited empirical information exists regarding botulinum toxin-A injector decision-making practices for adult upper limb post-stroke spasticity. The design of most studies prevents such an assessment, as injection sites and dosage are mandated by researcher protocols. This contrasts to usual injector practices, where individualized decision-making is the standard of care. DESIGN: Secondary data analysis from an Australian randomized controlled trial of 90 adults with upper limb post-stroke spasticity where experienced clinicians followed their standard clinical injecting practice rather than a mandated injection regimen. METHODS: Clinicians were hypothesized to tailor their injection practices according to the subject's degree of spasticity and/or the type of functional gain desired. Hypothesis testing was conducted using non-parametric analysis. RESULTS: Muscle selection and botulinum toxin-A dosage were not significantly associated with spasticity severity or with patient-identified goals. Between-site differences in injection practices suggested that injector beliefs, rather than patient characteristics, were the dominant feature driving botulinum toxin-A injection strategy for post-stroke upper limb spasticity. CONCLUSION: This result looks into the "black box" of rehabilitation, revealing significant variation in injector beliefs. Findings suggest that further scientific work is required to maximize the efficacy of botulinum toxin-A injections in post-stroke upper limb spasticity management. |
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Authors:
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Ian J Baguley; Melissa T Nott; Lynne Turner-Stokes; Stephen De Graaff; Pesi Katrak; Paul McCrory; Monica de Abadal; Andrew Hughes |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine Volume: 43 ISSN: 1651-2081 ISO Abbreviation: J Rehabil Med Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-10-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101088169 Medline TA: J Rehabil Med Country: Sweden |
Other Details:
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Languages: eng Pagination: 1032-7 Citation Subset: IM |
Affiliation:
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Westmead Hospital and The University of Sydney. E-mail: ian.baguley@swahs.health.nsw.gov.au. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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