The profile of patients and current practice of treatment of upper limb muscle spasticity with botulinum toxin type A: an international survey

Int J Rehabil Res. 2010 Sep;33(3):199-204. doi: 10.1097/MRR.0b013e328332f5e0.


To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31 countries were studied. Most patients were over 40 years old and had a stroke. Improvement of active function was the most frequent treatment goal in the first 3 months after the onset of upper limb spasticity, but was less common than passive function in the chronic stage. Pain relief was a common goal in both the stages. As a rule, clinicians intended to assess the effectiveness of treatment with impairment level scales. Functional outcome measures seem to be rarely used in clinical practice. The use of these measures should be encouraged to assess whether the reduction in muscle tone translates into functional benefit to patients and their caregivers.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Botulinum Toxins, Type A / administration & dosage
  • Botulinum Toxins, Type A / pharmacology
  • Botulinum Toxins, Type A / therapeutic use*
  • Cross-Sectional Studies
  • Female
  • Hemiplegia / complications
  • Hemiplegia / rehabilitation
  • Humans
  • Male
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology
  • Neuromuscular Agents / administration & dosage
  • Neuromuscular Agents / pharmacology
  • Neuromuscular Agents / therapeutic use*
  • Pain / drug therapy
  • Range of Motion, Articular / drug effects
  • Stroke / complications
  • Stroke Rehabilitation
  • Treatment Outcome
  • Upper Extremity*


  • Neuromuscular Agents
  • Botulinum Toxins, Type A
  • abobotulinumtoxinA