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Botulinum toxin A injection in the management of shoulder muscle overactivity: A scoping review

Published online by Cambridge University Press:  01 July 2019

Ian James Baguley ,
Hannah Louise Holman Barden ,
Emmanuel Jesulola  and
Melissa Therese Nott
Ian James Baguley*
Affiliation:
Brain Injury Rehabilitation Service, Westmead Hospital, Westmead, NSW, Australia Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
Hannah Louise Holman Barden
Affiliation:
Brain Injury Rehabilitation Service, Westmead Hospital, Westmead, NSW, Australia School of Community Health, Charles Sturt University, Albury, NSW, Australia
Emmanuel Jesulola
Affiliation:
Brain Injury Rehabilitation Service, Westmead Hospital, Westmead, NSW, Australia Paramedicine Discipline, Charles Sturt University, Bathurst, NSW, Australia
Melissa Therese Nott
Affiliation:
School of Community Health, Charles Sturt University, Albury, NSW, Australia
*
*Corresponding author. Email: ian.baguley@health.nsw.gov.au
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Abstract

The majority of studies examining botulinum toxin A (BTX-A) in the management of upper limb muscle overactivity and pain focus on the distal arm and hand. Research has begun to look at BTX-A efficacy in more proximal upper limb muscles, with literature showing equivocal findings. This scoping review identified 15 studies meeting inclusion criteria whose data were examined against three outcome variables: muscle overactivity, range of movement and pain. Overall, while the majority of injected participants improved on these variables, between-study methodological variability such as research design potentially underpowered studies and arbitrary decision making gave a high likelihood of influencing the interpretation of their results. Future research is warranted, with a robust focus on functional anatomy, a critical appraisal of how BTX-A may help the individual being studied and utilising individualised rather than protocol-driven research paradigms.

Type
Review Article
Information
Brain Impairment , Volume 21 , Issue 1 , March 2020 , pp. 86 - 98
Copyright
© Australasian Society for the Study of Brain Impairment 2019 

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