The Italian real-life post-stroke spasticity survey: Unmet needs in the management of spasticity with botulinum toxin type A

Alessandro Picelli, Alessio Baricich, Carlo Cisari, Stefano Paolucci, Nicola Smania, Giorgio Sandrini, Marco Aguggia, Enrico Alfonsi, Roberto Antonacci, Fabrizio Balestrieri, Michele Bertoni, Donatella Bonaiuti, Calogera Butera, Chiara Cesaretti, Carmelo Chisari, Paola Cicinelli, Marco Frontoni, Marialuisa Gandolfi, Pamela Latino, Giorgio MaggioniMario Manca, Paolo Manganotti, Salvatore Misceo, Marcello Romano, Andrea Santamato, Antonio Santoro, Alessandro Specchia, Carlo Trompetto, on behalf of the Italian Real-Life Survey Group

Research output: Contribution to journalArticle

Abstract

The present national survey seeking to identify unmet needs in the management of spasticity with botulinum toxin type A focused on the use of OnabotulinumoxinA, since this is the brand with the widest range of licensed indications in Italy. Physicians from twenty-four Italian neurorehabilitation units compiled a questionnaire about “real-life” post-stroke spasticity management. OnabotulinumtoxinA was reported to be used in the following average doses: upper limb 316.7 ± 79.1 units; lower limb 327.8 ± 152.3; upper and lower limb 543.7 ± 123.7 units. Of the physicians surveyed, 37.5% felt that increasing the frequency of OnabotulinumtoxinA injection would improve its efficacy; 70.8% use electrical stimulation/electromyography guidance (one fourth of injections with no instrumental guidance). Instrumental evaluation was used by 41.7% of the physicians. The participants expressed the view that early identification of post-stroke spasticity would be facilitated by the availability of a post-stroke checklist, and that this should be used by physiotherapists (91.7%), physiatrists (58.3%), family doctors (50%), stroke unit physicians (25%), patients and caregivers (79.2%). According to our findings, the management of poststroke spasticity has several unmet needs that, were they addressed, might improve these patients’ clinical outcomes and quality of life. These needs concern patient follow-up, where a clearly defined pathway is lacking; furthermore, there is a need to use maximum doses per treatment and to ensure early intervention on post-stroke spasticity.

Original languageEnglish
Pages (from-to)89-96
Number of pages8
JournalFunctional Neurology
Volume32
Issue number2
DOIs
Publication statusPublished - 2017

Keywords

  • Botulinum toxins
  • Disease management
  • Muscle spasticity
  • Rehabilitation

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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    Picelli, A., Baricich, A., Cisari, C., Paolucci, S., Smania, N., Sandrini, G., Aguggia, M., Alfonsi, E., Antonacci, R., Balestrieri, F., Bertoni, M., Bonaiuti, D., Butera, C., Cesaretti, C., Chisari, C., Cicinelli, P., Frontoni, M., Gandolfi, M., Latino, P., ... on behalf of the Italian Real-Life Survey Group (2017). The Italian real-life post-stroke spasticity survey: Unmet needs in the management of spasticity with botulinum toxin type A. Functional Neurology, 32(2), 89-96. https://doi.org/10.11138/FNeur/2017.32.2.089