Archive for category Pharmacological

[ARTICLE] Efficacy of physical therapy associated with botulinum toxin type A on functional performance in post-stroke spasticity: A randomized, double-blinded, placebo-controlled trial – Full Text

Abstract

The aim was to investigate if botulinum toxin type A (BTx-A) associated with physical therapy is superior to physical therapy alone in post stroke spasticity. A randomized, double-blinded controlled trial was performed in a rehabilitation unit on Northeastern, Brazil. Patients with post stroke spasticity were enrolled either to BTx-A injections and a pre-defined program of physical therapy or saline injections plus physical therapy. Primary endpoint was functional performance evaluated through time up and go test, six minutes walking test and Fugl-Meyer scale for upper limb. Secondary endpoint was spasticity improvement. Confidence interval was considered at 95%. Although there was a significant decrease in upper limbs flexor tonus (P<0.05) in the BTx-A group, there was no difference regarding functional performance after 9 months of treatment. When analyzing gait speed and performance, both groups showed a significant improvement in the third month of treatment, however it was not sustained over time. Although BTx-A shows superiority to improve muscle tone, physical therapy is the cornerstone to improve function in the upper limbs of post stroke patients.

Introduction

Stroke is the major cause of permanent and temporary functional incapacity worldwide among adults, affecting limb strength, motor control, balance and mobility.1 Spasticity is characterized by an increase in tonic stretch reflex movement velocity dependent and post-stroke spasticity is frequently associated with poor functional performance due to abnormal postural patterns, leading to retractions, atrophy, selective movement control loss, limb weakness, fibrosis and structured contractions.2 Moreover, impairment in activities of daily living (ADL) such as feeding, locomotion, proper hygiene and sleeping habits results in poor quality of life (QOL) and increased burden to relatives and caregivers.3

Several trials support the efficacy and safety of botulinum toxin type A (BTx-A) on spasticity treatment, reducing muscle permanent contraction and abnormal postural patterns, therefore, favoring rehabilitation process.4 Physical therapy has been described to be effective in post-stroke spastic patients through prevention of secondary incapacities and promoting behavioral reeducation, based on biomechanical and neurophysiological patterns. These techniques include physical exercises that focus on functional rehabilitation, reduction of limb spasticity, muscle strength improvement and sustained joint movement amplitude, besides proprioceptive and sensorial stimuli.5

Several trials with BTx-A show functional improvement in post-stroke spastic patients when compared to placebo, however, none have studied the impact of physical therapy alone.4

The aim of this trial was to investigate if BTx-A treatment associated with physical therapy is superior to physical therapy alone on functional performance in post-stroke spastic patients.[…]

 

Continue —> Efficacy of physical therapy associated with botulinum toxin type A on functional performance in post-stroke spasticity: A randomized, double-blinded, placebo-controlled trial

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[ARTICLE] Intensive therapy after botulinum toxin in adults with spasticity after stroke versus botulinum toxin alone or therapy alone: a pilot, feasibility randomized trial – Full Text

Abstract

Background

Botulinum toxin-A is provided for adults with post-stroke spasticity. Following injection, there is a variation in the rehabilitation therapy type and amount provided. The purpose of this study was to determine if it is feasible to add intensive therapy to botulinum toxin-A injections for adults with spasticity and whether it is likely to be beneficial.

Methods

Randomized trial with concealed allocation, assessor blinding, and intention to treat analysis. Thirty-seven adults (n = 3 incomplete or lost follow-up) with spasticity in the upper or lower limb were allocated to one of three groups: experimental group received a single dose of botulinum toxin-A plus an intensive therapy for 8 weeks, control group 1 received a single dose of botulinum toxin-A only, and control group 2 received intensive therapy only for 8 weeks. Feasibility was measured by examining recruitment, intervention (adherence, acceptability, safety), and measurement. Benefit was measured as goal achievement (Goal Attainment Scale), upper limb activity (Box and Block Test), walking (6-min walk test) and spasticity (Tardieu scale), at baseline (week 0), immediately after (week 8), and at three months (week 12).

Results

Overall recruitment fraction for the trial was 37% (eligibility fraction 39%, enrolment fraction 95%). The 26 participants allocated to receive intensive rehabilitation attended 97% of clinic-based sessions (mean 11 ± 2 h) and an averaged 58% (mean 52 ± 32 h) of prescribed 90 h of independent practice. There were no study-related adverse events reported. Although participants in all groups increased their goal attainment, there were no between-group differences for this or other outcomes at week 8 or 12.

Conclusion

Providing intensive therapy following botulinum toxin-A is feasible for adults with neurological spasticity. The study methods are appropriate for a future trial. A future trial would require 134 participants to detect a between-group difference of 7 points on Goal Attainment Scale t-scores with an alpha of 0.05 and power of 80%.

Background

Spasticity affects approximately 20% of stroke survivors [14] and is thought to significantly contribute to falls after stroke [56] as well as decreased activity participation [34]. Unsurprisingly, higher costs are thus incurred by patients with spasticity during the first year of survival [7]. Health professionals identify that addressing spasticity is a high priority during rehabilitation [8], and there is international consensus that localized spasticity (i.e., in the upper or lower limbs) is best managed with a combination of botulinum toxin and physical therapy [910]. While these consensus papers appear to agree, clinical management remains diverse [1112] and provides an ongoing challenge for both therapists and health services alike.

In Australia, stroke rehabilitation is guided by the Stroke Foundation clinical practice guidelines [13]. These guidelines recommend that management of moderate to severe spasticity include the use of botulinum toxin type A in additionto physical therapy interventions [13]. Unfortunately, clinical survey data suggests that occupational therapists and physiotherapists report providing therapy post-botulinum toxin type A injections less than a quarter of the time (an estimated 16%) [12]. This low rate of therapy provision suggests ongoing uncertainty among clinicians as to how to treat patients with spasticity. Such uncertainty is likely to stem from the lack of research studies that describe the type, frequency, intensity, and duration of therapy that is effective for people who have received botulinum toxin injections. While there are previous studies which have tested the efficacy of botulinum toxin type A for spasticity management after stroke [1416], what remains unknown is whether or not therapy should be provided to this group of patients.

To inform best practice in the treatment and rehabilitation of spasticity in people with neurological conditions, understanding whether the suggested combined effects of using both therapy and botulinum toxin type A together is more beneficial than botulinum toxin-A alone or physiotherapy interventions alone is key. Given the lack of research in this area, a large, powered randomized controlled trial is required. In preparation for this trial, it is key to understand both the feasibility and likely effects of the interventions; therefore, the research questions posed in this pilot study were:

  1. In neurological patients with spasticity, is it feasible to add intensive therapy to botulinum toxin-A injections if the therapy includes both clinic-based and home-based therapy sessions?
  2. Is adding intensive therapy likely to be of any benefit to goal attainment, upper limb activity, walking, and spasticity over botulinum toxin-A alone or intensive therapy alone?[…]

Continue —> Intensive therapy after botulinum toxin in adults with spasticity after stroke versus botulinum toxin alone or therapy alone: a pilot, feasibility randomized trial

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[ARTICLE] Botulinum Toxin Type A Treatment Combined with Intensive Rehabilitation for Gait Poststroke: A Preliminary Study – Full Text

Goal

To examine the effects of botulinum toxin type A (BoNT-A) treatment combined with intensive rehabilitation for gait compared with intensive rehabilitation alone in patients with chronic stroke.

Materials and Methods

A comparative case series design was used. Subjects were 19 patients with chronic stroke and spastic hemiplegia. In 9 patients (group I), BoNT-A was injected into spastic muscles of the affected lower limbs, followed by a 4-week inpatient intensive rehabilitation program. In the other 10 patients (group II), a 4-week inpatient intensive rehabilitation program alone was first provided (control period) followed by the same treatment protocol in group I. The Modified Ashworth Scale (MAS) scores, range of motion (ROM), gait speed in the 10-Meter Walking Test, 6-Minute Walking Distance Test (6MD) scores, Timed Up and Go Test (TUG) scores, and Berg Balance Scale scores were evaluated every 4 weeks following baseline assessments.

Results

All results except for the MAS score of knee flexor and the ROM of knee flexion improved in group I and the gait speed, 6MD, and TUG scores improved in group II. Intergroup comparisons at week 4 showed significantly greater improvements in the MAS score of ankle plantar flexor, ROM of ankle dorsiflexion, and 6MD in group I than in group II (P = .016, .011, and .009, respectively).

Conclusions

BoNT-A treatment for lower-limb spasticity, combined with intensive rehabilitation, was effective in improving spasticity and the 6MD compared with intensive rehabilitation alone in patients with chronic stroke.

 

Introduction

Lower-limb spasticity is a major problem in the management of patients after stroke12 because it causes gait disturbance.3 Such patients often have difficulty performing ankle dorsiflexion effectively during the swing phase of the gait cycle because of muscle spasticity and the inability to activate the ankle dorsiflexors.4 Calf muscle spasticity typically causes foot deformity, which results in the loss of heel strike, reduced toe clearance, and an inadequate base of support.5 These impairments decrease gait ability: cadence, stride length, speed, capacity, and stability.678910 Thus, lower-limb spasticity causes gait disturbance, which limits activities of daily living and, eventually, quality of life. Effective treatment of lower-limb spasticity is important in improving gait ability and enhancing the independence of patients after a stroke.

One of the primary treatments for lower-limb spasticity is botulinum toxin type A (BoNT-A). Although BoNT-A has been shown to reduce lower-limb spasticity in patients after stroke,111213its effects on improving gait ability have not been consistent among different previous studies. Pittock et al,14 Kaji et al,15 and Burbaud et al1 reported that BoNT-A injection reduced lower-limb spasticity but did not significantly improve gait pattern or speed. By contrast, Hesse et al11 and Mancini et al16 reported that BoNT-A treatment was effective in improving gait speed as well as lower-limb spasticity. Similarly, a systematic review and meta-analysis recently showed that BoNT-A treatment for lower-limb spasticity was associated with a small but statistically significant increase in gait speed.17 Consequently, the effect of BoNT-A alone for improving gait ability has been considered minimal.

To improve gait ability, adjunctive rehabilitation has recently been recommended to optimize the effects of BoNT-A treatment for lower-limb spasticity in poststroke patients.181920212223Gastaldi et al21 reported that BoNT-A treatment for lower-limb spasticity combined with additional stretching and physical therapy improved gait speed and single- and double-limb support during the stance phase of the gait cycle. Similarly, Roche et al22 reported that BoNT-A treatment for lower-limb spasticity combined with self-rehabilitation improved gait speed, capacity, and time to ascend and descend a flight of stairs. By contrast, Demetrios et al23 suggested no significant improvement in gait speed for 2 groups receiving BoNT-A treatment for lower-limb spasticity combined with high- or low-intensity rehabilitation. However, they concluded that both groups received BoNT-A treatment combined with regular rehabilitation, so there may have been insufficient variation of intensity during the rehabilitation phase. Therefore, the capacity of BoNT-A treatment combined with more intensive rehabilitation to improve gait ability remains unclear in poststroke patients.

The aim of this study was to examine the effects of BoNT-A treatment for lower-limb spasticity combined with intensive rehabilitation on improving gait ability in patients with chronic stroke and spastic hemiplegia compared with intensive rehabilitation alone. This study hypothesized that BoNT-A treatment combined with intensive rehabilitation would improve lower-limb spasticity and gait ability more effectively than intensive rehabilitation alone.[…]

 

Continue —> Botulinum Toxin Type A Treatment Combined with Intensive Rehabilitation for Gait Poststroke: A Preliminary Study – ScienceDirect

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[WEB SITE] Medical Marijuana for Epilepsy: What We Know

Rahul Guha, MD, July 26, 2018

Earlier this year, the Virginia State Legislature voted to expand the medical cannabis oil program in the Commonwealth. I have patients ask me about medical marijuana during every clinic visit. Here are a few talking points that will help guide the discussion with your patients.

Patients usually start the conversation by saying, “I read on my cousin’s Facebook wall that smoking marijuana can treat my epilepsy.”

Let’s take a step back and talk about the clinically important compounds in marijuana. The first is tetrahydrocannabinol (THC). It exerts its effect through a pair of G protein-coupled cannabinoid receptors named, conveniently, CB1 and CB2. The effect of THC on synapses produces the typical “high” that allows you to tolerate 11-minute guitar solos and most items on Taco Bell’s late-night menu. Early animal models showed mixed effects of THC on epilepsy and, in some cases, worsening seizures. This is different from cannabidiol (CBD), which interacts with a variety of other receptors. More promising effects reported in early animal models and anecdotal evidence from case reports spurred the movement towards clinical trials measuring the effect of CBD on epilepsy.

Will medical marijuana help my epilepsy?

We don’t know which epilepsy syndromes are most responsive to CBD. We don’t know the long-term effects of CBD or THC in the brains of patients with epilepsy. We have not agreed on the best dosing strategy for these medications. The best evidence for CBD in epilepsy comes from two recently published trials studying the effect of the drug in patients with Lennox-Gastaut syndrome and Dravet syndrome.[1,2] These diseases develop in childhood or infancy due to underlying genetic changes and are resistant to treatment.

In the studies, patients who were taking an average of six other antiepileptic medications received CBD as an add-on therapy to conventional medications. At 3 months’ follow-up, patients who received the CBD experienced a statistically significant decrease in average seizure frequency compared with placebo.

Can I use commercially available CBD?

Unfortunately, many of the products that are available online or over the counter at your local vape shop are not consistent with labeling. Simply put, there’s no guarantee that you are getting what’s advertised. In addition to unknown dosing and concentrations of THC and CBD, there is a possibility of contaminants, such as pesticides or other drugs, in the product. We can only guarantee the safety and efficacy of US Food and Drug Administration (FDA)-approved products.

How will CBD affect my other medications?

CBD is metabolized by the liver and inhibits cytochrome P450 (CYP) isoenzymes. This inhibition leads to increased levels of topiramate, zonisamide, eslicarbazepine, rufinamide, clobazam, and valproic acid.

Is it legal?

The FDA recently approved a CBD formulation, but there is currently no formulation of CBD that can be prescribed with a Drug Enforcement Administration (DEA) license. Under federal law, cannabis is still considered a Schedule I drug. It is only available through clinical trials and rare compassionate-use exceptions. Patients and providers should familiarize themselves with local laws before recommending CBD for the treatment of epilepsy.

 

via Medical Marijuana for Epilepsy: What We Know

 

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[Abstract] Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update

Abstract

Backgrounds:

Antiepileptic drugs (AEDs) are the mainstay of epilepsy treatment. Since 1989, 18 new AEDs have been licensed for clinical use and there are now 27 licensed AEDs in total for the treatment of patients with epilepsy. Furthermore, several AEDs are also used for the management of other medical conditions, e.g., pain and bipolar disorder. This has led to an increasingly widespread application of therapeutic drug monitoring (TDM) of AEDs, making AEDs among the most common medications for which TDM is performed. The aim of this review is to provide an overview of the indications for AED TDM, to provide key information for each individual AED in terms of the drug’s prescribing indications, key pharmacokinetic characteristics, associated drug-drug pharmacokinetic interactions and the value and the intricacies of TDM for each AED. The concept of the reference range is discussed as well as practical issues such as choice of sample types (total vs free concentrations in blood vs saliva) and sample collection and processing.

Methods:

The present review is based on published articles and searches in PubMed and Google Scholar, last searched March in 2018, in addition to references from relevant papers.

Results:

In total, 171 relevant references were identified and used to prepare this review.

Conclusions:

TDM provides a pragmatic approach to epilepsy care in that bespoke dose adjustments are undertaken based on drug concentrations so as to optimize clinical outcome. For the older first generation AEDs (carbamazepine, ethosuximide, phenobarbital, phenytoin, primidone and valproic acid), much data has accumulated in this regard. However, this is occurring increasingly for the new AEDs (brivaracetam, eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, piracetam, pregabalin, rufinamide, stiripentol, sulthiame, tiagabine, topiramate, vigabatrin and zonisamide).

via Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update

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[Abstract] Combined effects of botulinum toxin type A and repetitive transcranial magnetic stimulation with intensive motor training immediately after injection in a patient with chronic stroke: A case report

Highlights

  • 1-Hz repetitive transcranial magnetic stimulation with rehabilitation immediately after botulinum toxin type A injection in a stroke patient.
  • The spasticity, motor function, and usefulness of the paretic hand improved.
  • This is a possibility of shortening the intervention period of combined therapy.

Abstract

Study Design

Single case report.

Introduction

A previous study clarified that spasticity and motor function were improved by combined treatment with botulinum toxin type A (BTX) injection and 1-Hz repetitive transcranial magnetic stimulation (rTMS) with intensive motor training at 4 weeks after injection. However, it is not clear whether 1-Hz rTMS with intensive motor training immediately after BTX injection also improves spasticity and motor function in stroke patients.

Purpose of the Case Report

The purpose of this case report is to test the short- and long-term effects of BTX injection and rTMS with intensive motor training on the spasticity, motor function, and usefulness of the paretic hand in a stroke patient.

Methods

A 64-year-old male, who suffered from a right cerebral hemorrhage 53 months previously, participated in the present study. BTX was injected into the spastic muscles of the affected upper limb. He then received the new protocol for a total of 24 sessions. The Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), and Motor Activity Log, consisting of the amount of use and quality of movement scales, were assessed before and immediately after BTX injection, at discharge, and monthly for up to 5 months after discharge.

Results

For the short-term effects of the therapy, the MAS scores of the elbow and wrist, FMA score, and quality of movement score improved. For the long-term effects of the therapy, the MAS score of the fingers, FMA score, and amount of use score improved for up to 5 months after discharge.

Conclusions

The present case report showed the improvement of all assessments performed in the short and/or long term and suggest the possibility of shortening the intervention period of combined therapy of BTX and rTMS with intensive motor training.

via Combined effects of botulinum toxin type A and repetitive transcranial magnetic stimulation with intensive motor training immediately after injection in a patient with chronic stroke: A case report – Journal of Hand Therapy

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[Abstract] Sporadic distant neurotoxin effects in the chronic treatment of spasticity

Introduction/Background

Neurotoxin therapy is an effective component of comprehensive spasticity management. The two cases presented demonstrate adverse effects.

Material and method

Patient S is a 60-year-old female with right spastic hemiparesis due to left hemispheric stroke (age 46) treated with therapy, bracing, oral baclofen. Patient R is a 28-year-old female with left spastic hemiparesis due to hemispherectomy (age 6).

Results

For patient S, onabotulinumtoxinA (ONA) was initiated at 300 units (u) to the right upper extremity (RUE), advanced to 500u. She received injections every 3–3.5 months for over 9 years and continued to function independently. At routine follow-up, she related left upper extremity (LUE) weakness that she noted but did not report with her two prior injections. She denied any other symptoms. Examination revealed mild, diffuse LUE weakness, imaging was unremarkable and EMG demonstrated a chronic LUE axonal polyradiculopathy. ONA was continued at 300u to the RUE with somewhat lesser but maintained benefit without adverse effects.

For patient R, ONA was initiated at 400u to the LUE every three months for 13 rounds, advanced to 500u. Contralateral (RUE) weakness developed after the second round of 500u dosing. Diagnostic evaluation was notable only for increased insertional activity, fibrillationpotentials and decreased recruitment with subsequent long duration polyphasic motor unitpotentials. Unchanged with high dose steroids, weakness improved with IVIG. Repeat ONA with 500u resulted in good local effect, recurrent contralateral upper and lower extremity weakness. EMG demonstrated contralateral cervical, thoracic and lumbosacral axonal polyradiculopathy. Symptoms improved with IVIG. Patient declined subsequent ONA.

Conclusion

Both patients were treated with neurotoxin therapy for 3–9 years with good clinical response before developing the adverse reaction. Weakness distant to the injection sites is supported by electrodiagnostic findings of contralateral axonal polyradiculopathy. The clinical presentations suggest the possibility that the adverse effect of distant weakness may be immune-mediated and dose-related.

 

via Sporadic distant neurotoxin effects in the chronic treatment of spasticity – ScienceDirect

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[Abstract] Comparative hybrid effects of combining botulinum toxin A injection with bilateral robot-assisted, mirror or task-oriented therapy for upper extremity spasticity in patients with chronic stroke

Introduction/Background

Spasticity, a common impairment after stroke, has profound negative impact on outcomes in patients with stroke. Botulinum toxin type A (BoNT-A) injection combined with rehabilitation training is suggested for spasticity treatment. However, there is no recommendation about what kind of rehabilitation training is more appropriate than others following BoNT-A injection. The purpose of this study was to compare the effects of combining BoNT-A injection with bilateral robot-assisted (RT) or mirror (MT) or task-oriented (TT) therapy for upper extremity (UE) spasticity in patients with chronic stroke.

Material and method

Participants were randomly assigned to RT, or MT, or TT group after BoNT-A injection. The participants received 45 minutes of intervention per day, 3 days/week, for 8 weeks according the allocated results. In addition, all participants received 30 minutes of functional practice training. At pre-intervention, post-intervention and 3-month follow-up a blinded research assistant did outcome measures, including body function and structures by Fugl-Meyer Assessment (FMA), and Modified Ashworth Scale (MAS); activity and participation measures by Motor Activity Log (MAL), and Nottingham Extended Activities of Daily Living Scale (EADLS).

Results

Thirty-seven subjects met the inclusion criteria and underwent randomization, 13 were assigned to the RT; 12 to MT; and 12 to TT group. The 3 groups were well matched with regard to baseline characteristics and functional status. All groups had significant improvement in FMA, MAS and MAL post-intervention. There were no group differences in FMA, MAS, EADLs either post-intervention or at follow-up. There was a trend that TT group had higher quality of movement (QOM) in MAL post intervention than the other 2 groups (P = 0.07), at follow-up TT group had significantly higher QOM in MAL than the other 2 groups (P = 0.03).

Conclusion

Combining BoNT-A injection with TT resulted in better quality of UE movement in patients with spastic stroke than with RT or MT.

 

via Comparative hybrid effects of combining botulinum toxin A injection with bilateral robot-assisted, mirror or task-oriented therapy for upper extremity spasticity in patients with chronic stroke – ScienceDirect 

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[Abstract] How effective is physical therapy for gait muscle activity in hemiparetic patients who receive botulinum toxin injections?

BACKGROUND: Administration of botulinum neurotoxin A (BoNT-A) to the ankle plantar flexors in patients with hemiplegia reduces the strength of knee extension, which may decrease their walking ability. Studies have reported improvements in walking ability with physical therapy following BoNT-A administration. However, no previous studies have evaluated from an exercise physiology perspective the efficacy of physical therapy after BoNT-A administration for adult patients with hemiplegia.

AIM: To investigate the effects of physical therapy following BoNT-A administration on gait electromyography for patients with hemiparesis secondary to stroke.

DESIGN: Non-randomized controlled trial.

SETTING: Single center.

POPULATION: Thirty-five patients with chronic stroke with spasticity were assigned to BoNT-A monotherapy (n=18) or BoNT-A plus physical therapy (PT) (n=17).
METHODS: On the paralyzed side of the body, 300 single doses of BoNT-A were administered intramuscularly to the ankle plantar flexors. Physical therapy was performed for 2 weeks, starting from the day after administration. Gait electromyography was performed and gait parameters were measured immediately before and 2 weeks after BoNT- A administration. Relative muscle activity, co-activation indices, and walking time/distance were calculated for each phase.

RESULTS: For patients who received BoNT-A monotherapy, soleus activity during the loading response decreased 2 weeks after the intervention (p<0.01). For those who received BoNT-A+PT, biceps femoris activity and knee co-activation index during the loading response and tibialis anterior activity during the pre-swing phases increased, whereas soleus and rectus femoris activities during the swing phase decreased 2 weeks after the intervention (p<0.05). These rates of change were significantly greater than those for patients who received BoNT-A monotherapy (p<0.05).

CONCLUSIONS: Following BoNT-A monotherapy, soleus activity during the stance phase decreased and walking ability either remained unchanged or deteriorated. Following BoNT-A+PT, muscle activity and knee joint stability increased during the stance phase, and abnormal muscle activity during the swing phase was suppressed.

CLINICAL REHABILITATION IMPACT: If botulinum treatment of the ankle plantar flexors in stroke patients is targeted to those with low knee extension strength, or if it aims to improve leg swing on the paralyzed side of the body, then physical therapy following BoNT-A administration could be an essential part of the treatment strategy.

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via How effective is physical therapy for gait muscle activity in hemiparetic patients who receive botulinum toxin injections? – European Journal of Physical and Rehabilitation Medicine 2018 Jun 11 – Minerva Medica – Journals

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[WEB SITE] List of Seizures (Convulsions) Medications (60 Compared) – Drugs.com

Medications for Seizures (Convulsions)

Other names: Absence Seizure; Complex Partial Seizure; Fits

About Seizures:  A seizure or convulsion can be a sudden, violent, uncontrollable contraction of a group of muscles. A seizure can also be more subtle, consisting of only a brief “loss of contact” or a few moments of what appears to be daydreaming.

 

Drugs Used to Treat Seizures

The following list of medications are in some way related to, or used in the treatment of this condition.[…]

For the list of medications, Visit Site —> List of Seizures (Convulsions) Medications (60 Compared) – Drugs.com

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