M. Giovannelli, G. Borriello, P. Castri, L. Prosperini, C. Pozzilli
The aim of the study was to determine whether additional physiotherapy increases botulinum toxin type A effects in reducing spasticity in patients with multiple sclerosis. Thirty-eight patients with progressive multiple sclerosis affected by focal spasticity took part. For the intervention all patients received botulinum toxin type A; the treatment group also received additional physiotherapy to optimize management through passive or active exercise and stretching regimens. To measure objective and subjective level of spasticity, patients were assessed at baseline, 2, 4 and 12 weeks post treatment by the Modified Ashworth Scale and visual analogue scale. The authors concluded that physiotherapy in combination with botulinum toxin type A injection can improve overall response to botulinum toxin.
Clinical Rehabilitation, 2007, 21(4), 331-7