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Heterocyclic Drug Design and Development
Published in Rohit Dutt, Anil K. Sharma, Raj K. Keservani, Vandana Garg, Promising Drug Molecules of Natural Origin, 2020
Garima Verma, Mohammad Shaquiquzzaman, Mohammad Mumtaz Alam
Condition of muscle spasticity is associated with a number of clinical conditions like myositis, trauma, muscular, and ligamentous sprains and strains, tetanus, strychnine poisoning, neurological disorders and certain others as well (Fookes, 2018). In such cases, a category of drugs known as skeletal muscle relaxants is prescribed to the patients. Such drugs reduce tension in the muscles. They work either in the brain or spinal cord via blockage of excessively stimulated nerve pathways. Some commonly used muscle relaxants are baclofen, methocarbamol, tizanidine, and dantrolene. Those obtained from plants are given in Table 9.7.
Practical Sports NutritionChallenges and Solutions
Published in Elizabeth Broad, Sports Nutrition for Paralympic Athletes, 2019
The practicalities of athletes with CP eating while travelling need to be considered. Athletes who usually cope adequately with self-feeding at home may need some assistance in the confined space of an airplane seat. In addition, athletes with a high degree of muscle spasticity may require assistance with transfers and pressure relief.
Cerebral palsy, cerebellar ataxia, AIDS, phacomatosis, neuromuscular disorders, and epilepsy
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Christopher Kobylecki, Ling K. Lee, Mark W. Kellett
Cerebral palsy is becoming increasingly common as more premature low birthweight infants are surviving in neonatal intensive care units and are prone to insults to their central nervous system (CNS). Adverse events such as infection, cerebrovascular accident, or anoxia, in the prenatal and perinatal period, can permanently damage areas in the brain, which leads to the nonprogressive disorders of motor function seen in cerebral palsy. The most common manifestation is muscle spasticity (70%–80%), with athetoid, hypotonic, and ataxic motor disorders making up the rest. Intellectual capacity is directly related to the severity of physical impairment. The combination of mental, neurologic, and physical handicap results in urinary symptoms and incontinence being commoner in patients with cerebral palsy.
Do randomised controlled trials evaluating functional outcomes following botulinum neurotoxin-A align with focal spasticity guidelines? A systematic review
Published in Disability and Rehabilitation, 2022
Edwina Sutherland, Bridget Hill, Barby J. Singer, Stephen Ashford, Brian Hoare, Tandy Hastings-Ison, Klemens Fheodoroff, Steffen Berwick, Fiona Dobson, Gavin Williams
Although many studies did not identify a primary endpoint, the most common assessment timeframe was within 1–6 weeks following BoNT-A injection (81%). Thirty-six studies (69%) completed a follow-up between 3 and 6 months. Only four studies (7%) reported outcomes beyond 6 months. Given the duration of effect for BoNT-A is 4 months for most people [41], studies that were only assessed at 1–6 weeks post-injection may not capture related functional improvement for all participants. Furthermore, focal muscle spasticity can be a chronic impairment with long-term primary and secondary consequences. Given so few studies report outcomes exceeding 6 months following an intervention, it is difficult to determine the longer-term functional implications of the interventions examined within these RCTs.
A synthesis and appraisal of clinical practice guidelines, consensus statements and Cochrane systematic reviews for the management of focal spasticity in adults and children
Published in Disability and Rehabilitation, 2022
Gavin Williams, Barby J. Singer, Stephen Ashford, Brian Hoare, Tandy Hastings-Ison, Klemens Fheodoroff, Steffen Berwick, Edwina Sutherland, Bridget Hill
Search terms included guideline/or practice guideline/or clinical pathway/consensus, AND muscle spasticity/or muscle hypertonia/or muscle rigidity/or muscle tonus/spasm/or dystonia/or paraparesis, spastic/or hypertonicity/or dystonia. Titles and abstracts of retrieved articles were independently evaluated by two reviewers with full text retrieved where data were not sufficient to determine eligibility. CPG and consensus statements were assessed for methodological rigor and transparency of development using the Appraisal of Guidelines, Research and Evaluation (AGREE II) [16] instrument by four authors. The AGREE collaboration is an international team of guideline developers and researchers. The AGREE II statement is a 23-item appraisal tool that evaluates guideline development, reporting and evaluation. It states what is required for clinical implementation of a guideline. The AGREE II instrument was not applied to the Cochrane systematic reviews. Data were independently extracted by two reviewers including study characteristics, principles of management, outcome measures and adjunctive treatment. A third reviewer was used to resolve any disagreement.
Analysis of a 15-years’ experience in including shoulder muscles, when treating upper-limb spasticity post-stroke with botulinum toxin type A
Published in Topics in Stroke Rehabilitation, 2018
Maria Pais de Carvalho, Daniela Pinto, Melissa Gorayeb, Jorge Jacinto
From controlled clinical trials conducted to date, it is established that intramuscular botulinum toxin type A (BoNTA) offers the possibility of local treatment for focal spasticity without affecting sensation and without the systemic side-effects of oral medication. It have been consistently demonstrated that the treatment is safe and effective in reducing unwanted muscle spasticity and that the effect is maintained over repeated treatments3. Although BoNTA has been shown to reduce spasticity, its ability to improve function remains uncertain1. Clinical trials have demonstrated reduction in muscle tone, but improvement on functional level and activity limitations it’s more controversial4. One of the reasons for this is the diversity of patients’ deficits and impairments, and therefore the variety of treatment goals, as well as the difficulty of fitting the clinical findings in standardized measures, in order to quantify5.