2, 3 Importantly, 27–40% of affected individuals consider spasticity to be problematic and associated with significant functional impairments. Literature has shown that 53–78% of individuals with chronic SCI experience symptoms of spasticity. 1 Spasticity frequently occurs following damage to the central nervous system, such as spinal cord injury (SCI). However, there is a lack of high-quality evidence and further research is needed to confirm the efficacy of these interventions.Īlthough precise definitions vary, spasticity is commonly cited as ‘a motor disorder characterized by a velocity dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflexes, as one component of the upper motor neuron syndrome’. ConclusionĬhemodenervation with BoNT or phenol/alcohol may improve spasticity and function in individuals with SCI.
The effect of phenol/alcohol has the potential to last beyond 6 months study follow-up did not occur beyond this time point. An improvement in MAS was not always associated with improvement in function. All six studies on BoNT and three of the four studies on phenol/alcohol measuring MAS reported a decrease in at least one point. The Modified Ashworth Scale (MAS) was the most commonly used outcome measure.
The studies produced level 4 and level 5 evidence that chemodenervation with BoNT or alcohol/phenol can lead to improvement in outcome measurements classified in the body structure and function, as well as activity domains of the International Classification of Functioning, Disability and Health framework.
Owing to the clinically diverse nature of the studies, meta-analysis was deemed inappropriate. A total of 19 studies were included: 9 involving BoNT and 10 involving phenol/alcohol. Studies were assessed for eligibility and quality by two independent reviewers. Setting:ĮMBASE, MEDLINE, CINAHL, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials were searched for English language studies published up until March 2014. To systematically review the literature on chemodenervation with botulinum toxin (BoNT) or phenol/alcohol for treatment of limb spasticity following spinal cord injury (SCI).
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