Botulinum toxin A and repercussions on the ability to walk in individuals after a stroke: systematic review
DOI:
https://doi.org/10.11606/issn.2317-0190.v28i1a174183Keywords:
Stroke, Muscle Spasticity, Gait, Botulinum Toxins, Type AAbstract
The indication of botulinum toxin type A (BoNTA) for individuals with a history of stroke is a common clinical practice for reducing spasticity. Objective: To investigate whether the action of TBA without association with other interventions impacts on the ability of walking activity in post-stroke individuals. Method: A systematic review with studies from the Cochrane Central Register of Controlled Trials, MEDLINE, SciELO, PEDro, and LILACS databases, in English and Portuguese, between 2010 and 2020. Controlled clinical trials were included, with post-stroke participants aged between 18 and 50, of both sexes, submitted themselves to the application of BoNTA. The selection of the articles was carried out by two evaluators, with data extraction and quality evaluation of the evidence by PEDro, according to pre-established inclusion and exclusion criteria. Results: Of the 183 articles, four remained for final analysis. The application of TBA in post-stroke individuals occurred mostly in plantar flexors and the findings related to walking activity were increased stride, gait speed, distances covered when walking and reduced time to perform actions, such as climbing and go down steps. Conclusion: TBA improves the ability to walk in post-stroke individuals and knowledge of its benefits after application is essential to inform patients of the importance of taking advantage of this moment, to modify behaviors that accentuate the compensation patterns, which so much corroborate for the return of activity limitations and not due to the termination of the TBA action.
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References
Organização Mundial da Saúde. 10 principais causas de morte no mundo [texto na internet]. Brasília: OPAS; c2020 [citado 2020 Jun 23]. Disponível em: https://www.paho.org/bra/
World Health Organization. Health statistics and information systems – Projections of mortality and causes of death, 2015 and 2030 [text on the Internet]. Geneva: WHO; c2013. [cited 2020 jun 23]. Available from: https://www.who.int/healthinfo/global_burden_disease/projections2015_2030/en/
Damata SRR, Formiga LMF, Araújo AKS, Oliveira EAR, Oliveira AKS, Formiga RCF. Perfil epidemiológico dos idosos acometidos por acidente vascular cerebral. Rev Interd. 2016;9(1):107-17.
Gittler M, Davis AM. Guidelines for Adult Stroke Rehabilitation and Recovery. JAMA. 2018;319(8):820-1. Doi: https://doi.org/10.1001/jama.2017.22036
Francisco SEC. Modelos de intervenção em Fisioterapia nos pacientes com espasticidade pós AVC: revisão da literatura [Dissertação]. Lisboa: Instituto Politécnico de Lisboa; 2016.
Phadke CP, Ismail F, Boulias C, Gage W, Mochizuki G. The impact of post-stroke spasticity and botulinum toxin on standing balance: a systematic review. Expert Rev Neurother. 2014;14(3):319-27. Doi: https://doi.org/10.1586/14737175.2014.887443
Williams SA, Reid S, Elliott C, Shipman P, Valentine J. Muscle volume alterations in spastic muscles immediately following botulinum toxin type-A treatment in children with cerebral palsy. Dev Med Child Neurol. 2013;55(9):813-20. Doi: https://doi.org/10.1111/dmcn.12200
Farias N, Buchalla CM. A Classificação Internacional de Funcionalidade, Incapacidade e Saúde da Organização Mundial da Saúde: conceitos, usos e perspectivas. Rev Bras Epidemiol. 2005;8(2):187-93. Doi: http://dx.doi.org/10.1590/S1415-790X2005000200011
Schinwelski MJ, Sitek EJ, Wąż P, Sławek JW. Prevalence and predictors of post-stroke spasticity and its impact on daily living and quality of life. Neurol Neurochir Pol. 2019;53(6):449-57. Doi: https://doi.org/10.5603/PJNNS.a2019.0067
Datta Gupta A, Visvanathan R, Cameron I, Koblar SA, Howell S, Wilson D. Efficacy of botulinum toxin in modifying spasticity to improve walking and quality of life in post-stroke lower limb spasticity - a randomized double-blind placebo controlled study. BMC Neurol. 2019;19(1):96. Doi: https://doi.org/10.1186/s12883-019-1325-3
Sheean G, Lannin NA, Turner-Stokes L, Rawicki B, Snow BJ; Cerebral Palsy Institute. Botulinum toxin assessment, intervention and after-care for upper limb hypertonicity in adults: international consensus statement. Eur J Neurol. 2010;17 Suppl 2:74-93. Doi: https://doi.org/10.1111/j.1468-1331.2010.03129.x
Olver J, Esquenazi A, Fung VS, Singer BJ, Ward AB; Cerebral Palsy Institute. Botulinum toxin assessment, intervention and aftercare for lower limb disorders of movement and muscle tone in adults: international consensus statement. Eur J Neurol. 2010;17 Suppl 2:57-73. Doi: https://doi.org/10.1111/j.1468-1331.2010.03128.x
Sun LC, Chen R, Fu C, Chen Y, Wu Q, Chen R, et al. Efficacy and safety of Botulinum toxin type A for limb spasticity after stroke: a meta-analysis of randomized controlled trials. Biomed Res Int. 2019;2019:8329306. Doi: https://doi.org/10.1155/2019/8329306
Picelli A, Santamato A, Chemello E, Cinone N, Cisari C, Gandolfi M, et al. Adjuvant treatments associated with botulinum toxin injection for managing spasticity: An overview of the literature. Ann Phys Rehabil Med. 2019;62(4):291-6. Doi: https://doi.org/10.1016/j.rehab.2018.08.004
Park J, Chung ME. Botulinum toxin for central neuropathic pain. Toxins (Basel). 2018;10(6):224. Doi: https://doi.org/10.3390/toxins10060224
Yan X, Lan J, Liu Y, Miao J. Efficacy and Safety of Botulinum Toxin Type A in Spasticity Caused by Spinal Cord Injury: A Randomized, Controlled Trial. Med Sci Monit. 2018;24:8160-71. Doi: https://doi.org/10.12659/MSM.911296
Nasb M, Li Z, Youssef ASA, Dayoub L, Chen H. Comparison of the effects of modified constraint-induced movement therapy and intensive conventional therapy with a botulinum-a toxin injection on upper limb motor function recovery in patients with stroke. Libyan J Med. 2019;14(1):1609304. Doi: https://doi.org/10.1080/19932820.2019.1609304
Oh HM, Park GY, Choi YM, Koo HJ, Jang Y, Im S. The effects of Botulinum toxin injections on plantar flexor spasticity in different phases after stroke: a secondary analysis from a double-blind, randomized trial. PM R. 2018;10(8):789-97. Doi: https://doi.org/10.1016/j.pmrj.2018.02.011
Karadag-Saygi E, Cubukcu-Aydoseli K, Kablan N, Ofluoglu D. The role of kinesiotaping combined with botulinum toxin to reduce plantar flexors spasticity after stroke. Top Stroke Rehabil. 2010;17(4):318-22. Doi: https://doi.org/10.1310/tsr1704-318
Schinwelski M, Sławek J. Prevalence of spasticity following stroke and its impact on quality of life with emphasis on disability in activities of daily living. Systematic review. Neurol Neurochir Pol. 2010;44(4):404-11. Doi: https://doi.org/10.1016/s0028-3843(14)60300-5
Santos CMC, Pimenta CAM, Nobre MRC. The PICO strategy for the research question construction and evidence search. Rev Lat Am Enfermagem. 2007;15(3):508-11. Doi: https://doi.org/10.1590/s0104-11692007000300023
Shiwa RS, Costa LOP, Moser ADL, Aguiar IC, Oliveira LVF. PEDro: a base de dados de evidências em fisioterapia. Fisioter Mov. 2011;24(3):523-33. Doi: https://doi.org/10.1590/S0103-51502011000300017
Tang SF, Hong JP, McKay WB, Tang CW, Wu PH, Chu NK. Modification of altered ankle motor control after stroke using focal application of botulinum toxin type A. Clin Neurol Neurosurg. 2012;114(5):498-501. Doi: https://doi.org/10.1016/j.clineuro.2012.03.014
Lannin NA, Ada L, Levy T, English C, Ratcliffe J, Sindhusake D, et al. Intensive therapy after botulinum toxin in adults with spasticity after stroke versus botulinum toxin alone or therapy alone: a pilot, feasibility randomized trial. Pilot Feasibility Stud. 2018;4:82. Doi: https://doi.org/10.1186/s40814-018-0276-6
Roche N, Zory R, Sauthier A, Bonnyaud C, Pradon D, Bensmail D. Effect of rehabilitation and botulinum toxin injection on gait in chronic stroke patients: a randomized controlled study. J Rehabil Med. 2015;47(1):31-7. Doi: https://doi.org/10.2340/16501977-1887
Marinho C, Monteiro M, Santos L, Oliveira-Filho J, Pinto EB. Desempenho da marcha e qualidade de vida nos sobreviventes de avc: um estudo transversal. Rev Pesq Fisio. 2018;8(1):79-87. Doi: http://dx.doi.org/10.17267/2238-2704rpf.v8i1.1777
Li S. Spasticity, Motor Recovery, and Neural Plasticity after Stroke. Front Neurol. 2017;8:120. Doi: https://doi.org/10.3389/fneur.2017.00120
Maki T. Toxina botulínica tipo A e estimulação elétrica funcional no membro superior de pacientes crônicos pós-acidente vascular cerebral [Dissertação]. Campinas: Universidade Estadual de Campinas; 2005.
Zilli F, Lima ECBA, Kohler MC. Neuroplasticidade na reabilitação de pacientes acometidos por AVC espástico. Rev Ter Ocup Univ São Paulo. 2014;25(3):317-22. Doi: https://doi.org/10.11606/issn.2238-6149.v25i3p317-322
Simão SSS, Romero VU, BaraldiI K, Oda AL, Viana CF, Chiappetta ALML, et al. Avaliação clínica da relação entre postura, respiração e deglutição em paciente pós-acidente vascular cerebral na fase crônica: relato de caso. Rev CEFAC. 2013; 15 (5):1371-8. Doi: https://doi.org/10.1590/S1516-18462013000500035
Dunne JW, Gracies JM, Hayes M, Zeman B, Singer BJ; Multicentre Study Group. A prospective, multicentre, randomized, double-blind, placebo-controlled trial of onabotulinumtoxinA to treat plantarflexor/invertor overactivity after stroke. Clin Rehabil. 2012;26(9):787-97. Doi: https://doi.org/10.1177/0269215511432016
Tao W, Yan D, Li JH, Shi ZH. Gait improvement by low-dose botulinum toxin A injection treatment of the lower limbs in subacute stroke patients. J Phys Ther Sci. 2015;27(3):759-62. Doi: https://doi.org/10.1589/jpts.27.759
Souza A, Tavares JMRS. A marcha humana: uma abordagem biomecânica. UCH Gaia-Porto. 2010;1:1-9.
Ricci NA, Ferrarias GP, Molina KI, Dib PM, Alouche SR. Velocidade de marcha e autoeficácia em quedas em indivíduos com hemiparesia após Acidente Vascular Encefálico. Fisioter Pesq. 2015;22(2):191-6. Doi: https://doi.org/10.590/1809-2950/14484522022015
Novaes RD, Miranda AS, Dourado VZ. Velocidade usual da marcha em brasileiros de meia idade e idosos. Rev Bras Fisioter. 2011;15(2):117-22. Doi: https://doi.org/10.1590/S1413-35552011000200006
Nascimento LR, Caetano LCG, Freitas DCMA, Morais TM, Polese JC, Teixeira-Salmela LF. Diferentes instruções durante teste de velocidade de marcha determinam aumento significativo na velocidade máxima de indivíduos com hemiparesia crônica. Rev Bras Fisioter. 2012;16(2):122-7. Doi: https://doi.org/10.1590/S1413-35552012005000008
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