Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result Study
The study aimed to identify expert opinions and obtain recommendations on the management of post-stroke hemiplegic shoulder pain (HSP) and treatment with botulinum toxin A (BoNT-A). A multicenter Delphi study was conducted using an online survey designed by a committee of experts with at least 10 ye...
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MDPI AG
2025-01-01
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| Online Access: | https://www.mdpi.com/2072-6651/17/1/40 |
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| author | Carlos Cordero-García Irene de Torres Jacobo Formigo-Couceiro Lluis Guirao Mª Dolores Romero-Torres Sergio Otero-Villaverde Alberto Herrera Cristina Santa Antonio Mena-Rodriguez |
| author_facet | Carlos Cordero-García Irene de Torres Jacobo Formigo-Couceiro Lluis Guirao Mª Dolores Romero-Torres Sergio Otero-Villaverde Alberto Herrera Cristina Santa Antonio Mena-Rodriguez |
| author_sort | Carlos Cordero-García |
| collection | DOAJ |
| description | The study aimed to identify expert opinions and obtain recommendations on the management of post-stroke hemiplegic shoulder pain (HSP) and treatment with botulinum toxin A (BoNT-A). A multicenter Delphi study was conducted using an online survey designed by a committee of experts with at least 10 years of experience in post-stroke HSP management with BoNT-A in Spain. Forty-seven panelists (specialists with at least 5 years of experience in post-stroke HSP management with BoNT-A) rated their level of agreement in two rounds based on acceptance by ≥66.7% of them. In round 1, 245 statements on three dimensions were evaluated (diagnosis, treatment, and follow-up of the HSP patients treated with BoNT-A). A total of 159 statements (70.9%) were finally accepted after round 2. Experts recommended BoNT-A as soon as spasticity affects daily activities. They considered ultrasound as the preferred guided technique. Experts recommended regular assessments using validated scales and patient-reported outcomes to evaluate treatment goals and safety. In case of lack of response, experts suggested increasing the dose or number of treated muscles or considering alternative treatments. These consensus-based recommendations offer clinicians an approach to the management of post-stroke HSP with BoNT-A, supporting informed decision making. |
| format | Article |
| id | doaj-art-fe6b877ee1194ec886c4a40565716e04 |
| institution | Kabale University |
| issn | 2072-6651 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj-art-fe6b877ee1194ec886c4a40565716e042025-01-24T13:51:18ZengMDPI AGToxins2072-66512025-01-011714010.3390/toxins17010040Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result StudyCarlos Cordero-García0Irene de Torres1Jacobo Formigo-Couceiro2Lluis Guirao3Mª Dolores Romero-Torres4Sergio Otero-Villaverde5Alberto Herrera6Cristina Santa7Antonio Mena-Rodriguez8Juan Ramón Jiménez University Hospital, Ronda Exterior Norte s/n, 21005 Huelva, SpainReina Sofía University Hospital, Avda. Menéndez Pidal s/n, 14004 Córdoba, SpainUniversity Hospital of A Coruña, As Xubias, 84, 15006 A Coruña, SpainMútua Terrassa University Hospital, Plaça del Doctor Robert, 5, 08221 Terrassa, SpainVirgen Macarena University Hospital, Avda. Dr. Fedriani, 3, 41009 Sevilla, SpainUniversity Hospital of A Coruña, As Xubias, 84, 15006 A Coruña, SpainIpsen, Avda. Burgos, 21, 28036 Madrid, SpainIpsen, Avda. Burgos, 21, 28036 Madrid, SpainDoctor Negrín University Hospital of Gran Canaria, Pl. Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, SpainThe study aimed to identify expert opinions and obtain recommendations on the management of post-stroke hemiplegic shoulder pain (HSP) and treatment with botulinum toxin A (BoNT-A). A multicenter Delphi study was conducted using an online survey designed by a committee of experts with at least 10 years of experience in post-stroke HSP management with BoNT-A in Spain. Forty-seven panelists (specialists with at least 5 years of experience in post-stroke HSP management with BoNT-A) rated their level of agreement in two rounds based on acceptance by ≥66.7% of them. In round 1, 245 statements on three dimensions were evaluated (diagnosis, treatment, and follow-up of the HSP patients treated with BoNT-A). A total of 159 statements (70.9%) were finally accepted after round 2. Experts recommended BoNT-A as soon as spasticity affects daily activities. They considered ultrasound as the preferred guided technique. Experts recommended regular assessments using validated scales and patient-reported outcomes to evaluate treatment goals and safety. In case of lack of response, experts suggested increasing the dose or number of treated muscles or considering alternative treatments. These consensus-based recommendations offer clinicians an approach to the management of post-stroke HSP with BoNT-A, supporting informed decision making.https://www.mdpi.com/2072-6651/17/1/40Delphi methodhemiplegic shoulder pain (HSP)post-strokespasticitybotulinum toxin AabobotulinumtoxinA |
| spellingShingle | Carlos Cordero-García Irene de Torres Jacobo Formigo-Couceiro Lluis Guirao Mª Dolores Romero-Torres Sergio Otero-Villaverde Alberto Herrera Cristina Santa Antonio Mena-Rodriguez Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result Study Toxins Delphi method hemiplegic shoulder pain (HSP) post-stroke spasticity botulinum toxin A abobotulinumtoxinA |
| title | Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result Study |
| title_full | Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result Study |
| title_fullStr | Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result Study |
| title_full_unstemmed | Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result Study |
| title_short | Delphi Consensus on the Management of Spanish Patients with Post-Stroke Hemiplegic Shoulder Pain Treated with Botulinum Toxin A: Result Study |
| title_sort | delphi consensus on the management of spanish patients with post stroke hemiplegic shoulder pain treated with botulinum toxin a result study |
| topic | Delphi method hemiplegic shoulder pain (HSP) post-stroke spasticity botulinum toxin A abobotulinumtoxinA |
| url | https://www.mdpi.com/2072-6651/17/1/40 |
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