Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice
Objective: Describe abobotulinumtoxinA (aboBoNT-A) dosing parameters in the real-world management of lower limb spasticity (LLS). Methods: Prospective, observational study (NCT04050527) following ambulatory adults with unilateral LLS treated with aboBoNT-A. Results: The effectiveness population i...
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Medical Journals Sweden
2025-02-01
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| Series: | Journal of Rehabilitation Medicine |
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| Online Access: | https://medicaljournalssweden.se/jrm/article/view/42605 |
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| author | Richard D. Zorowitz Jorge Jacinto Stephen Ashford Mathieu Beneteau Pascal Maisonobe Christian Hannes Alberto Esquenazi |
| author_facet | Richard D. Zorowitz Jorge Jacinto Stephen Ashford Mathieu Beneteau Pascal Maisonobe Christian Hannes Alberto Esquenazi |
| author_sort | Richard D. Zorowitz |
| collection | DOAJ |
| description | Objective: Describe abobotulinumtoxinA (aboBoNT-A) dosing parameters in the real-world management of lower limb spasticity (LLS).
Methods: Prospective, observational study (NCT04050527) following ambulatory adults with unilateral LLS treated with aboBoNT-A.
Results: The effectiveness population included 384 adults with LLS. Across the study, total lower limb doses were higher in patients who received only lower limb injections (n = 131, median 771U) than those who also received ≥ 1 upper limb injection (n = 253, 567U). Total doses increased over subsequent cycles in both subgroups. Six muscles (gastrocnemius medial and lateral heads, soleus muscle, tibialis posterior, flexor digitorum longus, and flexor hallucis longus) were identified as the main targets for the treatment of LLS; other lower limb muscles were injected in fewer than 15% of patients. The most frequent therapy interventions (mean ± SD of 1.8 ± 1.3h/week with a qualified therapist and 5.3 ± 5.9h/week self-rehabilitation in Cycle 1) were task-specific practice, passive stretch, strength training, and positioning.
Conclusions: This study demonstrates how a diversity of muscle patterns are currently treated in routine practice where the primary goal was related to the lower limb and highlights important issues for further debate, such as potential underdosing and the need to balance upper and lower limb priorities when devising a treatment plan.
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| format | Article |
| id | doaj-art-3b2f594a2e0241358cc63526f28a4b6e |
| institution | Kabale University |
| issn | 1651-2081 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj-art-3b2f594a2e0241358cc63526f28a4b6e2025-02-07T08:15:09ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812025-02-015710.2340/jrm.v57.42605Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practiceRichard D. Zorowitz 0Jorge Jacinto 1Stephen Ashford 2Mathieu Beneteau 3Pascal Maisonobe 4Christian Hannes5Alberto Esquenazi 6MedStar Health, Washington and Georgetown University School of Medicine, Washington, DC, USACentro de Medicina de Reabilitação de Alcoitão, Serviço de Reabilitação de Adultos 3, Estoril, PortugalLondon North West University Healthcare NHS Trust, Regional Hyper-Acute Rehabilitation Unit, Northwick Park Hospital, London, UKIpsen, Boulogne-Billancourt, FranceIpsen, Boulogne-Billancourt, FranceIpsen, Munich, GermanyMossRehab Jefferson Health, Elkins Park, PA, USAObjective: Describe abobotulinumtoxinA (aboBoNT-A) dosing parameters in the real-world management of lower limb spasticity (LLS). Methods: Prospective, observational study (NCT04050527) following ambulatory adults with unilateral LLS treated with aboBoNT-A. Results: The effectiveness population included 384 adults with LLS. Across the study, total lower limb doses were higher in patients who received only lower limb injections (n = 131, median 771U) than those who also received ≥ 1 upper limb injection (n = 253, 567U). Total doses increased over subsequent cycles in both subgroups. Six muscles (gastrocnemius medial and lateral heads, soleus muscle, tibialis posterior, flexor digitorum longus, and flexor hallucis longus) were identified as the main targets for the treatment of LLS; other lower limb muscles were injected in fewer than 15% of patients. The most frequent therapy interventions (mean ± SD of 1.8 ± 1.3h/week with a qualified therapist and 5.3 ± 5.9h/week self-rehabilitation in Cycle 1) were task-specific practice, passive stretch, strength training, and positioning. Conclusions: This study demonstrates how a diversity of muscle patterns are currently treated in routine practice where the primary goal was related to the lower limb and highlights important issues for further debate, such as potential underdosing and the need to balance upper and lower limb priorities when devising a treatment plan. https://medicaljournalssweden.se/jrm/article/view/42605abobotulinumtoxinAbotulinum toxin Agoal attainment scalingrehabilitation |
| spellingShingle | Richard D. Zorowitz Jorge Jacinto Stephen Ashford Mathieu Beneteau Pascal Maisonobe Christian Hannes Alberto Esquenazi Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice Journal of Rehabilitation Medicine abobotulinumtoxinA botulinum toxin A goal attainment scaling rehabilitation |
| title | Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice |
| title_full | Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice |
| title_fullStr | Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice |
| title_full_unstemmed | Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice |
| title_short | Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice |
| title_sort | muscle selection and dosing in patients undergoing treatment with abobotulinumtoxina for lower limb spasticity in real world practice |
| topic | abobotulinumtoxinA botulinum toxin A goal attainment scaling rehabilitation |
| url | https://medicaljournalssweden.se/jrm/article/view/42605 |
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