The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach
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 databas...
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| Format: | Journal Article |
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SAGE Publications Ltd
2015
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1052236 http://hdl.handle.net/20.500.11937/37080 |
| _version_ | 1848754948710334464 |
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| author | Baker, J. Pereira, Gavin |
| author_facet | Baker, J. Pereira, Gavin |
| author_sort | Baker, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T08:48:31Z |
| format | Journal Article |
| id | curtin-20.500.11937-37080 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T08:48:31Z |
| publishDate | 2015 |
| publisher | SAGE Publications Ltd |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-370802017-09-13T13:59:39Z The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach Baker, J. Pereira, Gavin 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. 2015 Journal Article http://hdl.handle.net/20.500.11937/37080 10.1177/0269215514555036 http://purl.org/au-research/grants/nhmrc/1052236 SAGE Publications Ltd restricted |
| spellingShingle | Baker, J. Pereira, Gavin The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach |
| title | The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach |
| title_full | The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach |
| title_fullStr | The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach |
| title_full_unstemmed | The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach |
| title_short | The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach |
| title_sort | efficacy of botulinum toxin a on improving ease of care in the upper and lower limbs: a systematic review and meta-analysis using the grades of recommendation, assessment, development and evaluation approach |
| url | http://purl.org/au-research/grants/nhmrc/1052236 http://hdl.handle.net/20.500.11937/37080 |