A practical guide to optimizing the benefits of post-stroke spasticity interventions with botulinum toxin A: An international group consensus.
Gerard E Francisco, Alexander Balbert, Ganesh Bavikatte, Djamel Bensmail, Stefano Carda, Thierry Deltombe, Nathalie Draulans, Steven Escaldi, Raphael Gross, Jorge Jacinto, Nicholas Ketchum, Franco Molteni, Susana Moraleda, Michael W ODell, Rajiv Reebye, Patrik Säterö, Monica Verduzco-Gutierrez, Heather Walker, Jörg Wissel
PMID 33057730WHAT IT FOUND
Expert consensus recommends using Goal Attainment Scaling and instrumental guidance (EMG, ultrasound, or electrical stimulation) for botulinum toxin A injections in post-stroke spasticity.
Higher doses and flexible intervals may help meet patient goals, though evidence for specific adjunctive therapies like casting or shockwave treatment remains uncertain.
What this paper is
This is an international consensus statement providing expert recommendations on how to optimize botulinum toxin A injections for post-stroke spasticity. It summarizes existing literature and expert opinion on dosing, techniques, and adjunctive therapies, but it reports no new patient data or clinical trial results. Therefore, there are no findings from this paper itself to act on.
The easy way to misread this
Do not treat these recommendations as evidence that specific interventions (like higher doses or certain adjunctive therapies) are proven effective. The paper explicitly notes that many areas, such as optimal dosing and the value of adjunctive therapies, lack robust controlled trial data and rely on expert opinion.