Article

OBJECTIVE: To conduct a systematic review of the literature that examined the
effect of botulinum toxin type A on clonus. DATA SOURCES:
A literature search of
multiple databases (PubMed, Cochrane, Google Scholar, Embase) was performed to
identify articles published in English in the past 30 years (1986-2016). STUDY
SELECTION: Two reviewers independently applied the following inclusion criteria:
(1) any adult patients older than 18 years with upper motor lesion; (2) any
location and duration of clonus; and (3) subjective and objective measurements of
clonus tested at least 2 weeks after botulinum toxin injection. DATA EXTRACTION:
Two reviewers independently extracted the data and assessed the methodological
quality. A consensus method was used to solve disagreements. DATA SYNTHESIS: The
systematic review resulted in 164 articles, of which 14 met the inclusion
criteria: 3 were randomized controlled trials, 1 was nonrandomized, and 6 were
case series and 3 case studies. All studies (181 patients) showed improvement in
clonus: 6 of 14 results were statistically significant. Different scales were
used for clonus measurement, such as clonus score, patient diaries, clonus spasm
score, and electromyogram duration. CONCLUSIONS: Overall, there was preliminary
evidence indicating improvement in clonus after botulinum injection. The major
drawback with studies reviewed here was a large variation in the type of clonus
assessment tools, which also lacked validity, reliability, and sensitivity to
small changes in clonus.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS