Does the treatment of spastic equinovarus deformity following stroke with botulinum toxin increase gait velocity? A systematic review and meta-analysis.
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| Title: | Does the treatment of spastic equinovarus deformity following stroke with botulinum toxin increase gait velocity? A systematic review and meta-analysis. |
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| Authors: | Foley, N., Murie-Fernandez, M., Speechley, M., Salter, K., Sequeira, K., Teasell, R. |
| Source: | European Journal of Neurology. Dec2010, Vol. 17 Issue 12, p1419-1427. 9p. 1 Diagram, 3 Charts. |
| Subjects: | Botulinum toxin, Spasticity, Gait disorders, Meta-analysis, Leg abnormalities, Ankle, Movement disorders |
| Abstract: | While botulinum toxin-A (BT-A) has been used to treat lower-limb focal spasticity successfully, its effect on characteristics of gait has not been well defined. The objective of this systematic review was to establish the treatment effect associated with the use of BT-A for equinovarus to improve gait velocity following stroke, using a meta-analytic technique. Relevant studies were identified through a literature search encompassing the years 1985 to November 2009. Studies were included if (i) the sample was composed of adult subjects recovering from either first or subsequent stroke, presenting with spastic equinovarus deformity of the ankle preventing full active dorsiflexion, and (ii) subjects who received BT-A were compared with subjects who had received a placebo, or (iii) in the absence of a placebo-controlled condition, subject had received BT-A and was assessed before and after treatment. A standardized mean difference (SMD) ± standard error and 95% confidence interval (CI) for gait velocity between the treatment and control group was calculated for each study, using Hedges's g, and the results pooled. Eight trials, five randomized controlled trials, and three single group intervention studies were included. Data representing 228 subjects were available for pooled analysis. Treatment with BT-A was associated with a small improvement in gait velocity (Hedge's g = 0.193 ± 0.081; 95% CI: 0.033 to 0.353, P < 0.018) representing an increase of 0.044 meters/s. The use of BT-A for lower-limb post-stroke equinovarus because of spasticity was associated with a small, but statistically significant increase in gait velocity. [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 55274247 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Does the treatment of spastic equinovarus deformity following stroke with botulinum toxin increase gait velocity? A systematic review and meta-analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Foley%2C+N%2E%22">Foley, N.</searchLink><br /><searchLink fieldCode="AR" term="%22Murie-Fernandez%2C+M%2E%22">Murie-Fernandez, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Speechley%2C+M%2E%22">Speechley, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Salter%2C+K%2E%22">Salter, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Sequeira%2C+K%2E%22">Sequeira, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Teasell%2C+R%2E%22">Teasell, R.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Dec2010, Vol. 17 Issue 12, p1419-1427. 9p. 1 Diagram, 3 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Botulinum+toxin%22">Botulinum toxin</searchLink><br /><searchLink fieldCode="DE" term="%22Spasticity%22">Spasticity</searchLink><br /><searchLink fieldCode="DE" term="%22Gait+disorders%22">Gait disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Leg+abnormalities%22">Leg abnormalities</searchLink><br /><searchLink fieldCode="DE" term="%22Ankle%22">Ankle</searchLink><br /><searchLink fieldCode="DE" term="%22Movement+disorders%22">Movement disorders</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: While botulinum toxin-A (BT-A) has been used to treat lower-limb focal spasticity successfully, its effect on characteristics of gait has not been well defined. The objective of this systematic review was to establish the treatment effect associated with the use of BT-A for equinovarus to improve gait velocity following stroke, using a meta-analytic technique. Relevant studies were identified through a literature search encompassing the years 1985 to November 2009. Studies were included if (i) the sample was composed of adult subjects recovering from either first or subsequent stroke, presenting with spastic equinovarus deformity of the ankle preventing full active dorsiflexion, and (ii) subjects who received BT-A were compared with subjects who had received a placebo, or (iii) in the absence of a placebo-controlled condition, subject had received BT-A and was assessed before and after treatment. A standardized mean difference (SMD) ± standard error and 95% confidence interval (CI) for gait velocity between the treatment and control group was calculated for each study, using Hedges's g, and the results pooled. Eight trials, five randomized controlled trials, and three single group intervention studies were included. Data representing 228 subjects were available for pooled analysis. Treatment with BT-A was associated with a small improvement in gait velocity (Hedge's g = 0.193 ± 0.081; 95% CI: 0.033 to 0.353, P < 0.018) representing an increase of 0.044 meters/s. The use of BT-A for lower-limb post-stroke equinovarus because of spasticity was associated with a small, but statistically significant increase in gait velocity. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/j.1468-1331.2010.03084.x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 9 StartPage: 1419 Subjects: – SubjectFull: Botulinum toxin Type: general – SubjectFull: Spasticity Type: general – SubjectFull: Gait disorders Type: general – SubjectFull: Meta-analysis Type: general – SubjectFull: Leg abnormalities Type: general – SubjectFull: Ankle Type: general – SubjectFull: Movement disorders Type: general Titles: – TitleFull: Does the treatment of spastic equinovarus deformity following stroke with botulinum toxin increase gait velocity? A systematic review and meta-analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Foley, N. – PersonEntity: Name: NameFull: Murie-Fernandez, M. – PersonEntity: Name: NameFull: Speechley, M. – PersonEntity: Name: NameFull: Salter, K. – PersonEntity: Name: NameFull: Sequeira, K. – PersonEntity: Name: NameFull: Teasell, R. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 12 Text: Dec2010 Type: published Y: 2010 Identifiers: – Type: issn-print Value: 13515101 Numbering: – Type: volume Value: 17 – Type: issue Value: 12 Titles: – TitleFull: European Journal of Neurology Type: main |
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