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Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey

Spasticity of the upper extremity can result in severe pain, along with many complications that can impair a patient’s activities of daily living. Failure to treat patients with spasticity of the upper limb can result in a decrease in the range of motion of joints and contracture development, leadin...

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Autores principales: Kassam, Farris, Lim, Brendan, Afroz, Sadia, Boissonnault, Ève, Reebye, Rajiv, Finlayson, Heather, Winston, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866374/
https://www.ncbi.nlm.nih.gov/pubmed/36668878
http://dx.doi.org/10.3390/toxins15010058
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author Kassam, Farris
Lim, Brendan
Afroz, Sadia
Boissonnault, Ève
Reebye, Rajiv
Finlayson, Heather
Winston, Paul
author_facet Kassam, Farris
Lim, Brendan
Afroz, Sadia
Boissonnault, Ève
Reebye, Rajiv
Finlayson, Heather
Winston, Paul
author_sort Kassam, Farris
collection PubMed
description Spasticity of the upper extremity can result in severe pain, along with many complications that can impair a patient’s activities of daily living. Failure to treat patients with spasticity of the upper limb can result in a decrease in the range of motion of joints and contracture development, leading to further restriction in daily activities. We aimed to investigate the practice patterns of Canadian physicians who utilize Botulinum toxin type-A (BoNT-A) injections in the management of shoulder spasticity. 50 Canadian Physical Medicine and Rehabilitation (PM&R) physicians completed a survey with an estimated completion rate of (36.23%). The demographics of the survey participants came from a variety of provinces, clinical settings, and patient populations. The most common muscle injected for shoulder adduction and internal rotation spasticity was the pectoralis major, this was followed by latissimus dorsi, pectoralis minor, subscapularis and teres major. Injection of BoNT-A for problematic post-stroke shoulder spasticity was common, with (81.48%) of participants responding that it was always or often used in their management of post-stroke spasticity (PSS). Dosing of BoNT-A demonstrated variability for the muscle injected as well as the type of toxin used. The goals of the patients, caregivers, and practitioners were used to help guide the management of these patients. As a result, the practice patterns of Canadian physicians who treat shoulder spasticity are varied, due to numerous patient factors. Future studies are needed to analyze optimal treatment patterns, and the development of algorithms to standardize care.
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spelling pubmed-98663742023-01-22 Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey Kassam, Farris Lim, Brendan Afroz, Sadia Boissonnault, Ève Reebye, Rajiv Finlayson, Heather Winston, Paul Toxins (Basel) Article Spasticity of the upper extremity can result in severe pain, along with many complications that can impair a patient’s activities of daily living. Failure to treat patients with spasticity of the upper limb can result in a decrease in the range of motion of joints and contracture development, leading to further restriction in daily activities. We aimed to investigate the practice patterns of Canadian physicians who utilize Botulinum toxin type-A (BoNT-A) injections in the management of shoulder spasticity. 50 Canadian Physical Medicine and Rehabilitation (PM&R) physicians completed a survey with an estimated completion rate of (36.23%). The demographics of the survey participants came from a variety of provinces, clinical settings, and patient populations. The most common muscle injected for shoulder adduction and internal rotation spasticity was the pectoralis major, this was followed by latissimus dorsi, pectoralis minor, subscapularis and teres major. Injection of BoNT-A for problematic post-stroke shoulder spasticity was common, with (81.48%) of participants responding that it was always or often used in their management of post-stroke spasticity (PSS). Dosing of BoNT-A demonstrated variability for the muscle injected as well as the type of toxin used. The goals of the patients, caregivers, and practitioners were used to help guide the management of these patients. As a result, the practice patterns of Canadian physicians who treat shoulder spasticity are varied, due to numerous patient factors. Future studies are needed to analyze optimal treatment patterns, and the development of algorithms to standardize care. MDPI 2023-01-10 /pmc/articles/PMC9866374/ /pubmed/36668878 http://dx.doi.org/10.3390/toxins15010058 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kassam, Farris
Lim, Brendan
Afroz, Sadia
Boissonnault, Ève
Reebye, Rajiv
Finlayson, Heather
Winston, Paul
Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey
title Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey
title_full Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey
title_fullStr Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey
title_full_unstemmed Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey
title_short Canadian Physicians’ Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey
title_sort canadian physicians’ use of intramuscular botulinum toxin injections for shoulder spasticity: a national cross-sectional survey
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866374/
https://www.ncbi.nlm.nih.gov/pubmed/36668878
http://dx.doi.org/10.3390/toxins15010058
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