Article

The aim of the study was to report physician experience-based
"real-world" treatment patterns with botulinum toxin type A in patients with
stroke and traumatic brain injury. DESIGN: A prospective, multicenter,
international observational registry design was used. RESULTS: Six hundred
twenty-seven participants with stroke and 132 participants with traumatic brain
injury were assessed and treated by 17 more experienced physicians and 12 less
experienced physicians.
Due to the limited usage of abobotulinumtoxinA Dysport
and incobotulinumtoxinA Xeomin, data were reported on onabotulinumtoxinA BOTOX
only. Based on physician experience, onabotulinumtoxinA doses were statistically
different with larger mean doses injected by more experienced physicians in the
upper limb (59.9 [39.0], P = 0.001) and in the lower limb (101.8 [69.2], P <
0.001). Treated deformities significantly differed for both upper limb and lower
limb (P < 0.001). More experienced physicians showed a larger mean change in
Ashworth Scale scores from baseline for the equinovarus/equinus foot and stiff
knee (P = 0.001 and 0.03). Less experienced physicians showed a larger mean
change in Ashworth Scale scores from baseline for the adducted thigh (P = 0.05).
Less experienced physicians had statistically significant larger change in hand
pain scores for clenched fist deformity treatment at follow-up compared with more
experienced physicians (P = 0.01). Physician experience demonstrated a
significant difference on patients reported satisfaction toward their secondary
goal with higher scores for more experienced physician (P = 0.04). CONCLUSIONS:
This international registry provides clinical nuances of treatment based on
physician clinical experience in a robust sample size.

Langue : ANGLAIS