Article

OBJECTIVES: A systematic review and meta-analysis using the Grades of
Recommendation, Assessment, Development and Evaluation (GRADE) approach;
evaluating Botulinum Toxin type A efficacy on improving ease of care in the upper / lower limb. DATA SOURCES: Pubmed, Cinahl, Amed, Embase and Cochrane
databases. English Language. Search to July 2014.
REVIEW METHODS:
All randomized,
placebo controlled trials on adults with difficulty in caring for the upper/lower
limb resulting from spasticity of any origin and treated with a single dose of
Botulinum Toxin A. Evidence quality was assessed by GRADE. RESULTS: A total of 32
studies were reviewed. Meta-analysis was carried out on 11 upper limb and three
lower limb studies. Evidence quality for the upper limb was moderate. A
significant result for Botulinum Toxin A was found at four to 12 weeks for the
upper limb (SMD 0.80, CI 0.55, 1.06, p < 0.0001). The effects were maintained for
up to six months (SMD 0.48, CI 0.34, 0.62, p < 0.0001).
Evidence quality was very
low for the lower limb. Meta-analysis was only possible for global assessment of
benefit. No significant effect was found. ( PATIENT: RR 1.37 CI (0.94, 2.00) p =
0.11; clinician: RR 1.06 (0.84, 1.34) p = 0.60.) CONCLUSION: Botulinum Toxin A
improves ease of care in the upper limb for up to six months. No conclusion can
be drawn for the lower limb.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS