Electrical Stimulation of Injected Muscles to Boost Botulinum Toxin Effect on Spasticity: Rationale,Systematic Review and State of the Art |
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| Authors: | Alessandro Picelli Mirko Filippetti Giorgio Sandrini Cristina Tassorelli Roberto De Icco Nicola Smania Stefano Tamburin |
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| Institution: | 1.Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy; (A.P.); (M.F.); (N.S.);2.Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (G.S.); (C.T.); (R.D.I.);3.Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy |
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| Abstract: | Botulinum toxin type A (BoNT-A) represents a first-line treatment for spasticity, a common disabling consequence of many neurological diseases. Electrical stimulation of motor nerve endings has been reported to boost the effect of BoNT-A. To date, a wide range of stimulation protocols has been proposed in the literature. We conducted a systematic review of current literature on the protocols of electrical stimulation to boost the effect of BoNT-A injection in patients with spasticity. A systematic search using the MeSH terms “electric stimulation”, “muscle spasticity” and “botulinum toxins” and strings “electric stimulation mh] OR electrical stimulation AND muscle spasticity mh] OR spasticity AND botulinum toxins mh] OR botulinum toxin type A” was conducted on PubMed, Scopus, PEDro and Cochrane library electronic databases. Full-text articles written in English and published from database inception to March 2021 were included. Data on patient characteristics, electrical stimulation protocols and outcome measures were collected. This systematic review provides a complete overview of current literature on the role of electrical stimulation to boost the effect of BoNT-A injection for spasticity, together with a critical discussion on its rationale based on the neurobiology of BoNT-A uptake. |
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| Keywords: | botulinum toxins electrical stimulation muscle spasticity physical therapy modalities rehabilitation |
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