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Cited by 120Botulinum Toxin and Related Neurological DisordersStroke Rehabilitation and RecoveryCerebral Palsy and Movement Disorders

The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.

A systematic review: efficacy of botulinum toxin in walking and quality of life in post-stroke lower limb spasticity

Open access
Gupta, Anupam Datta, Chu, Wing Hong, Howell, Stuart, Chakraborty, Subhojit, Koblar, Simon, Visvanathan, Renuka, Cameron, Ian, Wilson, David·2018·Systematic Reviews
DOI 10.1186/s13643-017-0670-9PMC PMC5755326
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Abstract

BACKGROUND: Improved walking is one of the highest priorities in people living with stroke. Post-stroke lower limb spasticity (PSLLS) impedes walking and quality of life (QOL). The understanding of the evidence of improved walking and QOL following botulinum toxin (BoNTA) injection is not clear. We performed a systematic review of the randomized control trials (RCT) to evaluate the effectiveness of BoNTA injection on walking and QOL in PSLLS. METHODS: We searched PubMed, Web of Science, Embase, CINAHL, ProQuest Thesis and Dissertation checks, Google Scholar, WHO International Clinical Trial Registry Platform, ClinicalTrials.gov , Cochrane, and ANZ and EU Clinical Trials Register for RCTs looking at improvement in walking and QOL following injection of BoNTA in PSLLS. The original search was carried out prior to 16 September 2015. We conducted an additional verifying search on CINHAL, EMBASE, and MEDLINE (via PubMed) from 16 September 2015 to 6 June 2017 using the same clauses as the previous search. Methodological quality of the individual studies was critically appraised using Joanna Briggs Institute's instrument. Only placebo-controlled RCTs looking at improvement in walking and QOL were included in the review. RESULTS: Of 2026 records, we found 107 full-text records. Amongst them, we found five RCTs qualifying our criteria. No new trials were found from the verifying search. Two independent reviewers assessed methodological validity prior to inclusion in the review using Joanna Briggs Institute's appraisal instrument. Two studies reported significant improvement in gait velocity (p = 0.020) and < 0.05, respectively. One study showed significant improvement in 2-min-walking distance (p < 0.05). QOL was recorded in one study without any significant improvement. Meta-analysis of reviewed studies could not be performed because of different methods of assessing walking ability, small sample size with large confidence interval and issues such as lack of power calculations in some studies. Findings from our systematic and detailed study identify the need for a well-designed RCT to adequately investigate the issues highlighted. CONCLUSIONS: This review could not conclude there was sufficient evidence to support or refute improvement on walking or QOL following BoNTA injection. Reasons for this are discussed, and methods for future RCTs are developed.

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  • Gates et al. in 2018 on Abstrackr reported sensitivity and specificity rates of 79-96% and 19-90% for identifying eligible records after screening 0.7-10.3% of records for 3 systematic reviews and 1 descriptive analysis study.

    “Gates et al. [19] conducted another study on Abstrackr in 2018 and reported sensitivity and specificity rates of 79-96% and 19-90% for identifying eligible records after screening 0.7-10.3% of records for 3 SRs and 1 descriptive analysis study.”

    From Abstract screening using the automated tool Rayyan: results of effectiveness in three diagnostic test accuracy systematic reviews (2022) · cites this paper as [19]

    The Methods (Review searches) and Results (Description of the included studies; page numbers unavailable) describe screening records for a review of botulinum toxin in post-stroke spasticity. Searches for Gates, Abstrackr, the stated sensitivity and specificity ranges, and the screening percentages found no passage addressing the claimed study. Our copy therefore cannot verify those figures. (LLM, conf=0.78)

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Research works printed but not linked: 1

  1. Esquenazi A. The human and economic burden of post stroke spasticity and muscle overactivity. J Clin Outcomes Management. 2011;18:607–14.

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Metadata

Authors
Gupta, A. D., Chu, W. H., Howell, S., Chakraborty, S., Koblar, S., Visvanathan, R., Cameron, I., & Wilson, D.
Affiliations
  • Queen Elizabeth Hospital (AU)
  • The University of Adelaide (AU)
  • University of Cambridge (GB)
  • South Australian Health and Medical Research Institute (AU)
  • The University of Sydney (AU)
Corresponding author
Gupta, Anupam Datta
ORCID
Venue
Systematic Reviews
Publisher
Springer Science and Business Media LLC
Published
2018-01-05
Volume
7
Issue
1
Pages
1-1
ISSN
2046-4053 (ISSN-L)
DOI
10.1186/s13643-017-0670-9
PMC
PMC5755326
OpenAlex
W2782235379
Cited by
120
References
31
Citations by year
2026: 3 · 2025: 18 · 2024: 18 · 2023: 12 · 2022: 21 · 2021: 28 · 2020: 7 · 2019: 7 · 2018: 6
FWCI
1.89
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Systematic Reviews (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Apollo (cc-by)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Botulinum Toxin and Related Neurological Disorders
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Rehabilitation › Cerebral Palsy and Movement Disorders
Keywords
botulinum toxin, post-stroke spasticity, lower limb spasticity, stroke, gait, walking speed, walking distance, quality of life
MeSH terms
Botulinum Toxins, Humans, Muscle Spasticity, Neuromuscular Agents, Quality of Life, Randomized Controlled Trials as Topic, Walking, Stroke, Lower Extremity

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