Deans' stroke musings: The efficacy of Botulinum Toxin A for spasticity and pain in adults: a systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, November 11, 2019

The efficacy of Botulinum Toxin A for spasticity and pain in adults: a systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach

How can you say botox has any efficacy when you don't specify anything on cures for spasticity? I expect a cure, not just a reduction in spasticity. I would have to say botox has zero efficacy in curing spasticity by itself. Bad research design. The mentors and senior researchers need retraining on the whole point of stroke research. PROTOCOLS THAT LEAD TO 100% RECOVERY. This completely failed that test.

The efficacy of Botulinum Toxin A for spasticity and pain in adults: a systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach

Clinical Rehabilitation27(12) 1084 –1096© The Author(s) 2013Reprints and permissions: sagepub.co.uk/journalsPermissions.navDOI: 10.1177/0269215513491274cre.sagepub.com
CLINICALREHABILITATION
491274
CRE

27

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10.1177/0269215513491274Clinical RehabilitationBaker and Pereira2013
1
Physiotherapy Department, Poole Hospital NHS Foundation Trust, Poole, UK
2
University of Western Australia, Perth, Australia
The efficacy of Botulinum Toxin A for spasticity and pain in adults: a systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach
Jennifer A Baker
1
and Gavin Pereira
2

Abstract

Objectives

: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach to evaluate Botulinum Toxin Type A efficacy on spasticity and pain in the upper/lower limb in adults.
Data Sources
: Pubmed, Cinahl, Amed, Embase and Cochrane Databases. English language. 1989 to April 2013.
Review methods:
All randomized controlled trials on adults with spasticity of any origin in the upper or lower limb, treated with a single dose of Botulinum Toxin A, with outcome measures for pain or spasticity. Quality was assessed by GRADE, which uses a transparent, structured process for developing and presenting summaries of evidence, including its quality, for systematic reviews.
Results
:A total of 37 studies were reviewed. A meta-analysis was carried out on 10 for pain and 21 for spasticity. Evidence quality was low/very low for pain. No significant effect was found in the upper limb (standardised mean difference (SMD) = 0.44, confidence interval (CI) –0.02 to 0.90, Z = 1.88,
P =0.06), and no effect was found in the lower limb (risk ratio (RR) = 1.01 CI 0.19 to 5.36, Z = 0.02,
P =0.99).Evidence quality for spasticity was moderate. Significant effects were found for Botulinum Toxin in the upper limb (weighted mean difference (WMD) = 0.88, CI 0.63 to 1.14, Z = 6.86,
P <0.00001), and the lower limb (RR=2.42, CI 1.60 to 3.65, Z=4.18,
P <0.0001).
Conclusion
:The use of Botulinum Toxin A is supported for upper and lower limb spasticity. Further evidence is needed for spasticity-related pain. Evidence quality is reduced by inadequate study design.