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Publications

IAB produces and offers know-how, e.g. medical law, scales for rating movement disorders and therapy effects, reference books, videos, virtual products and guidelines.

Just Arrived

» Botulinum toxin therapy in the SARS‑CoV‑2 pandemic: patient perceptions from a German cohort: Dressler D, Adib Saberi F

The SARS-CoV-2 virus pandemic has provoked drastic countermeasures including shutdowns of public services. We wanted to describe the efects of a 6 week shutdown of a large German botulinum toxin (BT) outpatient clinics on patients and their well-being. ...

» PäPKi® for Relaxation and Regeneration with Demand-Oriented Nutrition

The PäPKi® method diagnoses and treats functional developmental disorders in babies and children (ICD10: F80.-83.) as well as functional disorders in adulthood.

» Here we present more short films about PäPKi®

The PäPKi® method diagnoses and treats functional developmental disorders in babies and children (ICD10: F80.-83.) as well as functional disorders in adulthood. ...

» Introductory Chapter: Botulinum Toxin Type A Therapy in Dystonia and Spasticity – What are Current Practical Applications?: Raymond L. Rosales and Dirk Dressler

Published in the book: Botulinum Toxin Therapy Manual for Dystonia and Spasticity

Medical Law

» Rechtsreport: Bei Fristüberschreitung gilt die Genehmigung als erteilt

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» (Deutsch) Antrag auf Kostenerstattung für die Behandlung mit Botulinum Toxin im Off Label Use

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» (Deutsch) § 2 SGB V Leistungen

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» (Deutsch) Änderungen im Patientenrechtegesetz für Patientenanträge

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» Guidelines 2013 on Good Distribution Practice of Medicinal Products for Human Use

  INFORMATION FROM EUROPEAN UNION INSTITUTIONS, BODIES, OFFICES AND AGENCIES OTHER ACTS Guidelines of 7 March 2013 on Good Distribution Practice of Medicinal Products for Human Use (2013/C 68/01) English Version: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2013:068:0001:0014:EN:PDF German Version: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2013:068:0001:0014:DE:PDF Source: Official Journal of the European Union

» (Deutsch) BEANTRAGUNG VON LEISTUNGEN IM OFF-LABEL-VERFAHREN: VERÄNDERUNGEN DURCH DAS NEUE PATIENTENRECHTEGESETZ

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» (Deutsch) GBA zu Spasmodischer Dysphonie

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» (Deutsch) Aktion Hartmannbund Niedersachsen

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» (Deutsch) Verbot der Unterstützung von Kongressteilnahmen durch die Industrie?

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» (Deutsch) BUNDESSOZIALGERICHT Urteil vom 8.11.2011, B 1 KR 19/10 R

(Deutsch) BUNDESSOZIALGERICHT Urteil vom 8.11.2011, B 1 KR 19/10 R Krankenversicherung - Verordnung eines Arzneimittels während und außerhalb eines arzneimittelrechtlichen Zulassungsverfahrens jenseits seiner bestehenden Zulassung nur bei wissenschaftlichen Erkenntnissen über Nutzen und Risiken des Mittels aufgrund von Phase III-Studien - Bindung von Hochschulambulanzen an die im ambulanten Bereich geltenden leistungsrechtlichen Begrenzungen des Anspruchs der Versicherten auf Versorgung mit Fertigarzneimitteln - kein Ersatz der Zulassungsentscheidung durch die bloße Möglichkeit einer Zulassung im Verfahren nach § 25b Abs 2 AMG 1976

Guidlines

» International Guidelines for the Treatment of Huntington’s Disease: European Network of Huntington’s Disease

The European Huntington's Disease Network (EHDN) commissioned an international task force to provide global evidence-based recommendations for everyday clinical practice for treatment of Huntington's disease (HD). ....

» Evidence-based guidelines: ParkinsonNet

To provide decision support for everyday clinical practice, we develop evidence-based guidelines for Parkinson’s disease using international standards including AGREE. ....

» Guidelines 2013 on Good Distribution Practice of Medicinal Products for Human Use

  INFORMATION FROM EUROPEAN UNION INSTITUTIONS, BODIES, OFFICES AND AGENCIES OTHER ACTS Guidelines of 7 March 2013 on Good Distribution Practice of Medicinal Products for Human Use (2013/C 68/01) English Version: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2013:068:0001:0014:EN:PDF German Version: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2013:068:0001:0014:DE:PDF Source: Official Journal of the European Union

Consensus Papers

» Consensus Guidelines for Botulinum Toxin Therapy: General Algorithms and Dosing Tables for Dystonia and Spasticy: Dressler D et al.

Abstract: Botulinum toxin (BT) therapy is a complex and highly individualised therapy defined by treatment algorithms and injection schemes describing its target muscles and their dosing. ...

» The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy: Heinen F et al.

Abstract: An interdisciplinary European group of clinical experts in the field of movement disorders and experienced Botulinum toxin users has updated the consensus for the use of Botulinum toxin in the treatment of children with cerebral palsy (CP). ...

» Intrathecal Baclofen Therapy in Germany: Proceeding of IAB – Interdisciplinary Working Group for Movement Disorders Consensus Meeting: Dressler D et al.

Abstract: Continuous intrathecal Baclofen application (ITB) through an intracorporeal pump system is widely used in adults and children with spasticity of spinal and supraspinal origin. Currently, about 1200 new ITB pump systems are implanted in Germany each year. ....

» Strategies for Treatment of Dystonia: Special Task Force on Treatment of Dystonia formed by IAB – Interdisciplinary Working Group for Movement Disorders: Dressler D et al.

Abstract: Treatment of dystonias is generally symptomatic. To produce sufficient therapy effects, therefore, frequently a multimodal and interdisciplinary therapeutic approach becomes necessary, combining botulinum toxin therapy, deep brain stimulation, oral antidystonic drugs, adjuvant drugs and rehabilitation therapy including physiotherapy, occupational therapy, re-training, speech therapy, psychotherapy and sociotherapy ....

» Botulinum Toxin Therapy for Treatment of Spasticity in Multiple Sclerosis: Review and Recommendations of the IAB-Interdisciplinary Working Group for Movement Disorders Task Force: Dressler D et al.

Abstract Botulinum toxin (BT) therapy is an established treatment of spasticity due to stroke. For multiple sclerosis (MS) spasticity this is not the case. IAB-Interdisciplinary Working Group for Movement Disorders formed a task force to explore the use of BT therapy for treatment of MS spasticity. ....

» Defining Spasticity: A New Approach Considering Current Movement Disorders Terminology and Botulinumtoxin Therapy Review and Recommendations of IAB – Interdisciplinary Working Group for Movement Disorders Task Force: Dressler D et al.

Abstract: Spasticity is a symptom occurring in many neurological conditions including stroke, multiple sclerosis, hypoxic brain damage, traumatic brain injury, tumours and heredodegenerative diseases. ....

» Review article – The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy: Heinen F et al.

a b s t r a c t An interdisciplinary European group of clinical experts in the field of movement disordersand experienced Botulinum toxin users has updated the consensus for the use of Botulinum toxin in the treatment of children with cerebral palsy (CP). ....

Key Papers

» (Deutsch) Aktion Hartmannbund Niedersachsen

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» The Pathogenesis of Dystonia – Past, Present and Future: Jinnah HA

Goals for this presentation: Genetics, Anatomy, Physiology

» Botulinum toxin therapy in patients with oral anticoagulation – is it safe?: Schader C et al.

Abstract When used therapeutically, botulinum toxin (BT) has to be injected into its target tissues. ...

» TRANSLATIONAL BOTULINUM TOXIN RESEARCH: COMPARING BT DRUGS – Dressler D

3rd Chinese Botulinum Toxin Forum Back to Basic 2018

» Cannabis – an Innovative Opportunity or a Bubble?

Marijuana - is a new billion dollar market emerging?

» New DBS Brochure Produced by Dystonie-und-Du e. V. (DyD)

The brochure can be ordered from DyD for a fee of € 2.         Selbsthilfeorganisation Dystonie-und-Du e. V. Volker Kreiss Madenburgweg 7 b 76187 Karlsruhe E-Mail: volker.kreiss@dysd.de Homepage: www.dysd.de

» Systematic Review of Rehabilitation in Focal Dystonias: Classification and Recommendations: Prudente CN et al.

Background: Rehabilitation interventions are rarely utilized as an alternative or adjunct therapy for focal dystonias. Reasons for limited utilization are unknown, but lack of conclusive evidence of effectiveness is likely a crucial factor. ...

» Abstracts of Scientific Papers and Posters Presented at the Annual Meeting of the Association of Academic Physiatrists Medical Student Category Award Winner TUNING ALGORITHMS FOR CONTROL INTERFACES FOR USERS WITH UPPER LIMB IMPAIRMENTS: Zhou L

Objective: It is estimated that 4 million Americans with disabilities living in community settings use wheeled mobility devices and millions more access computers. Approximately 40% of these people cannot operate these devices adequately due to diminished upper-limb motor control, sensory limitations, and cognitive...

» Management of Spasticity Associated Pain with Botulinum Toxin A: Wissel J et al.

Abstract: Lesions of the central nervous system often result in an upper motor neuron syndrome including spasticity, paresis with pyramidal signs, and painful spasms. Pharmacological treatment with oral antispasticity drugs is frequently associated with systemic side effects which limit their clinical use....

» Intrathecal Baclofen for Spastic Hypertonia From Stroke Editorial Comment: Meythaler JM et al.

Background and Purpose: We sought to determine whether continuous intrathecal delivery of baclofen can effectivelydecrease spastic hypertonia due to stroke...

» Best Clinical Practice in Botulinum Toxin Treatment for Children with Cerebral Palsy: Strobl W et al.

Abstract: Botulinum toxin A (BoNT-A) is considered a safe and effective therapy for children with cerebral palsy (CP), especially in the hands of experienced injectors and for the majority of children. ....

» Botulinum Toxin Type a for Upper Limb Spasticity Following Stroke: An Open-Label Study With Individualised, Flexible Injection Regimens: Slawek J et al.

Abstract: Current antispastic medications are unsatisfacto-ry for spasticity treatment,but botulinum toxin type A(BTX-A) shows promise as a new therapeutic option. ....

» Treatments for spasticity and pain in multiple sclerosis: a systematic review: Beard S et al.

Objectives: To identify the drug treatments currently available for the management of spasticity and pain inmultiple sclerosis (MS), and to evaluate their clinical andcost-effectiveness ....

» International Neurology – A Clinical Approach: (Editors) Lisak RP et al.

Preface: The idea for this text ,International Neurology: A Clinical Approach, grew out of the involvement of the editors at the first two international neurology meetings held in Vietnam. ....

» Split-Screen Video Demonstration of Sonography-Guided Muscle Identification and Injection of Botulinum Toxin: Fietzek U M et al.

Abstract: A standardization of injection procedures for the various botulinum toxin (BoNT) indications has not been achieved to date. ....

» A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS-ES Task Force: Albanese A M et al.

To review the literature on primary dystonia and dystonia plus and to provide evidence-based recommendations. Primary dystonia and dystonia plus are chronic and often disabling conditions with a widespread spectrum mainly in young people. ....

» The management of spastic equinus in cerebral palsy: Cobeljic G et al.

Abstract: Equinus of the foot is the most common deformity in children with spastic cerebral palsy. Patients with cerebral palsy who are able to walk may have different problems because of an equinus deformity. ....

» Botulinum toxin type A in the treatment of lower-limb spasticity in children with cerebral palsy: Camargo CHF et al.

Abstract – We evaluated the safety ans effectiveness of botulinum toxin A (BoNT/A) in the treatment of spasticity in 20 children with spastic diplegic cerebral palsy (CP). ....

» Randomized trial of botulinum toxin to prevent pes cavus progression in pediatric charcot-marie-tooth disease type 1A: Burns J et al.

Abstract: Pes cavus in Charcot–Marie–Tooth disease type1A (CMT1A) is thought to be due to muscle imbalance of the lower leg. Botulinum toxin type A (BoNT-A) can modify foot deformity in other conditions of muscle imbalance. ....

» Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in young children with hemiplegic cerebral palsy: a randomised controlled trial methods paper: Hoare BJ et al.

Background: Use of Botulinum toxin-A (BoNT-A) for treatment of upper limb spasticity in children with cerebral palsy has become routine clinical practice in many paediatric treatment centres worldwide. ...

» Indications and effects of botulinum toxin A for obstetric brachial plexus injury: a systematic literature review: Gobets D et al.

AIM: To give an overview of indications for the use of botulinum toxin A (BoNT-A) treatment for children with obstetric brachial plexus injury (OBPI), and to present the best available evidence of the effectiveness of this treatment. ...

» A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity: Kawamura A et al.

This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. ...

» Can botulinum toxin type A injection technique influence the clinical outcome of patients with post-stroke upper limb spasticity? A randomized controlled trial comparing manual needle placement and ultrasound-guided injection techniques: Santamato A et al.

Background: Botulinum toxin type A is a first-line treatment for post-stroke focal spasticity, and the accuracy in delivering the toxin to the target muscles may influence the treatment outcome. Our aim was to compare the reduction of spasticity and the related finger position at rest improvement in post-stroke patients treated with botulinum toxin type A in upper limb muscles using ultrasound guidance and manual needle placement. ...

» Upper Extremity Spasticity in Children With Cerebral Palsy: A Randomized, Double-Blind, Placebo-Controlled Study of the Short-Term Outcomes of Treatment With Botulinum A Toxin: Koman LA et al.

Purpose: Botulinum A toxin (BoNT-A) injections are used widely to manage lower extremity spasticity in children with cerebral palsy. ...

» High dose botulinum toxin A for the treatment of lower extremity hypertonicity in children with cerebral palsy: Willis AW et al.

Abstract: The aim of this study was to determine the safety profile of high dose (15–25 units/kg) of botulinum toxin A (BTX-A) in children with cerebral palsy (CP) and increased lower extremity muscle tone. ...

» Treatment of adductor spasticity with BTX-A in children with CP: a randomized, double-blind, placebo-controlled study: Mall V et al.

Adductor spasticity in children with cerebral palsy (CP) impairs motor function and development. ...

» Low Prevalence of Botulinum Toxin-A Adverse Effects: Good Safety Profile or Underreporting?: Aimer O et al.

Introduction: The incidence of botulinum toxin type A (BoNT-A) injections related adverse effects (AE) is relatively high in literature. Many of injections are carried out yearly in our Physical and Rehabilitation Medicine (PRM) unit, however only 4 adverse effects have been reported since 2010. ...

» GPi-DBS in Huntington’s disease: Results on motor function and cognition in a 72-year-old case: Fasano A et al.

Abstract: Huntington’s disease (HD) produces debilitating motor abnormalities that are poorly responsive to medical therapy. ...

» Systemic adverse events following botulinum toxin A therapy in children with cerebral palsy: Naidu K et al.

AIM: We studied the incidence of incontinence and respiratory events in children with cerebral palsy who received injections of botulinum toxin A (BoNT-A). ...

» Botulinum neurotoxin-A in idiopathic chondrolysis: a report of two cases: Khoshhal KI et al.

Two cases of idiopathic chondrolysis were treated by botulinum neurotoxin-A injections, with a favorable outcome. ...

» Botulinum toxin type A in the management of oromandibular dystonia and bruxism: Tintner R and Jankovic J

Oromandibular dystonia (OMD) refers to involuntary spasms of masticatory, lingual and pharyngeal muscles. ...

» Two-year placebo-controlled trial of botulinum toxin A for leg spasticity in cerebral palsy: Moore AP et al.

Background: The controlled evidence favoring botulinum toxin A (BtA) treatment for spasticity incerebral palsy is based on short-term studies. ...

» Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy: a Cochrane systematic review: Wasiak J et al.

Background: Cerebral palsy (CP) is a central nervous system deficit resulting from a non-progressive lesion in the developing brain. ...

» Pharmacologic management of spasticity in multiple sclerosis: Pappalardo A et al.

Abstract: Spasticity is very common in people with multiple sclerosis (MS). ...

» Botulinum toxin (Dysport) treatment of the spastic gastrocnemius muscle in children with cerebral palsy: a randomized trial comparing two injection volumes: Hu GC et al.

Objective: To compare the effect of equivalent doses in two different volumes of botulinum toxin type A (Dysport) on gastrocnemius spasticity. ...

» Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in young children with hemiplegic cerebral palsy: a randomised controlled trial methods paper: Hoare BJ et al.

Objective: To compare the outcome of manual needle placement, electrical stimulation and ultrasonography-guided techniques for botulinum toxin injection into the forearm muscles of adults with arm spasticity....

» Adhesive taping vs. daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial: Santamato A et al.

Objective: To compare the effectiveness of two procedures increasing the botulinum toxin type A effect for wrist and finger flexor spasticity after stroke. ...

» Efficacy of Therapeutic Ultrasoundand Transcutaneous Electrical NerveStimulation Compared With BotulinumToxin Type A in the Treatment of SpasticEquinus in Adults With Chronic Stroke: A Pilot Randomized Controlled Trial: Picelli A et al.

Background: Therapeutic ultrasound and transcutaneous electrical nerve stimulation (TENS) have been described as being effective in the treatment of spasticity. ...

» Botulinum toxin assessment, intervention and after-care for lower limb spasticity in children with cerebral palsy: international consensus statement: Love SC et al.

Botulinum neurotoxin type-A (BoNT-A) has been used in association with other interventions in the management of spasticity in children with cerebral palsy (CP) foralmost two decades. ...

» Botulinum neurotoxin type A injections reduce spasticity in mild to moderate hereditary spastic paraplegia – Report of 19 cases: Hecht MJ et al.

Abstract: Hereditary spastic paraplegia (HSP) is characterized by lower extremity spasticity. Symptomatic therapy generally includes physical therapy and oral antispastic agents, in selected cases intrathecal baclofen. ...

» Adductor release and chemodenervation in children with cerebral palsy: a pilot study in 16 children: Khot A et al.

Purpose: A pilot study with short-term outcomes of acombined surgical and medica lintervention form anagement of generalized lower limb spasticity, hip displacement and contractures of adductors in children with bilateral spastic cerebral palsy. ...

» A Randomized Controlled Trial of Selective Neurotomy Versus Botulinum Toxin for Spastic Equinovarus Foot After Stroke: Bollens B et al.

Introduction: Stroke is one of the leading causes of mortality and is a major cause of handicap worldwide. ...

» Muscle Activation Patterns When Passively Stretching Spastic Lower Limb Muscles of Children with Cerebral Palsy: Bar-On L et al.

Abstract: The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. ...

» Splint: the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial: Maas JC et al.

Background: Range of motion deficits of the lower extremity occur in about the half of the children with spastic cerebral palsy (CP). Over time, these impairments can cause joint deformities and deviations in the children’s gaitpattern, leading to limitations in moblity. ...

» Gait analysis to assess the effects of botulinum toxin type A treatment in cerebral palsy: an open-label study in 10 children with equinus gait pattern: Wissel J et al.

Abstract: Botulinum toxin type A (BTX‐A) injections induce a dose‐related decrease in muscle tone and increased joint mobility in adults with spasticity and children with cerebral palsy. ...

» The effects of botulinum toxin type A on improvement and dynamic spastic equinus correction in children with cerebral palsy – preliminary results: Colovic H et al.

Introduction: Cerebral palsy (CP) refers to a group of non-progressive nervous system disorders with musculoskeletal manifestation due to an early brain developmental disorder[1]. ...

» AACPDM systematic review of the effectiveness of therapy for children with cerebral palsy following botulinum toxin-A injections: Lannin N et al.

Abtract: The aim of this review was to assess the effectiveness of therapy interventions on improving outcomes in children with cerebral palsy (CP) who have received botulinum toxin A (BTX-A) injections to either upper or lower limb muscles. ...

» A French observational study of botulinum toxin use in the management of children with cerebral palsy: BOTULOSCOPE: Chale´at-Valayer E et al.

Background: Dystonia and spasticity are common symptoms in children with Cerebral Palsy(CP), whose management is a challenge to overcome in order to enable the harmonized development of motor function during growth. ...

» Clinical assessment of spasticity in children with cerebral palsy: A critical review of available instruments: Scholtes VAB et al.

This study reviews the instruments used for the clinical assessment of spasticity in children with cerebral palsy, and evaluates their compliance with the concept of spasticity, defined as a velocity-dependent increase in muscle tone to passive stretch. ...

» Effects of early spasticity treatment on children with hemiplegic cerebral palsy: a preliminary study: Zonto MB et al.

Objective: To compare motor and functional performance of two groups of children with hemiplegic cerebral palsy (HCP). Only the studygroup (SG) received early treatment of spasticity with botulinum neurotoxin type A (BXT-A). ...

» Time Course Analysis of the Effects of Botulinum Toxin Type A on Elbow Spasticity Based on Biomechanic and Electromyographic Parameters: Lee HM et al.

Objective: To quantify changes of elbow spasticity over time after botulinum toxin type A (BTX-A) injection in the upper extremity of stroke patients. ...

» Botox – the magical spell of dentistry: A literature review: Lova F, Ahsan A

Introduction: Botox (botulinum toxin-BTX or botulinum neurotoxin) is a protease exotoxin released by Clostridium botulinum, which is a gram-positive, rod-shaped, anaerobic, spore-forming, motile bacterium. ...

» Botulinum toxin in children with cerebral palsy: Singhi P, Ray M

Abstract: Botulinum toxin is a neurotoxin that blocks the synaptic release of acetylcholine from cholinergic nerve terminals mainly at the neuromuscular junction, resulting in irreversible loss of motor end plates. ...

» Botulinum toxin type A in the management of oromandibular dystonia and bruxism: Tintner R, Jankovic J

Oromandibular dystonia (OMD) refers to involuntary spasms of masticatory, lingual and pharyngeal muscles. ...

» Dose-Dependent Response to Intramuscular Botulinum ToxinType A for Upper-Limb Spasticity in Patients After a Stroke: Childers MK et al.

Objective: To test the hypothesis that intramuscular (IM) botulinum toxin type A (BTX) reduces excessive muscle tone in a dose-dependent manner in the elbow, wrist, and fingers of patients who experience spasticity after a stroke. ......

» Does loss of spasticity matter? A 10-year follow-up after selective dorsal rhizotomy in cerebral palsy: Tedroff K et al.

AIM: The aim of this study was to evaluate the long-term effectsof selective dorsal rhizotomy (SDR) in children with cerebral palsy (CP). ...

» Low-dose/high-concentration localized botulinum toxin A improves upper limb movement and function in children with hemiplegic cerebral palsy: Lowe K et al.

The objective was to determine the effects of low-dose, high-concentration, dual localized botulinum toxin A (BTX-A)injections on upper limb movement quality and function. Study design was an evaluator-blinded, randomized, controlled trial. ...

» Botulinum toxin type A injections for the management of muscletightness following total hip arthroplasty: a case series: Bhave A et al.

Background: Development of hip adductor, tensor fascia lata, and rectus femoris musclecontractures following total hip arthroplasties are quite common, with some patients failing toimprove despite treatment with a variety of non-operative modalities. ...

» Influence of botulinum toxin therapy on postural control and lower limb intersegmental coordination in children with spastic cerebral palsy: Degelaen M et al.

Abstract: Botulinum toxin injections may significantly improve lower limb kinematics ingait of children with spastic forms of cerebral palsy. ...

» Analgesic effects of botulinum toxin A: a randomized, placebo-controlled clinical trial: Barwood S et al.

Postoperative pain in children with spastic cerebral palsy(CP) is often attributed to muscle spasm and is difficult tomanage using opiates and benzodiazepines. ...

» Botulinum toxin A injections do not improve surface EMG patterns during gait in children with cerebral palsy – A randomized controlled study: van der Houwen LEE et al.

Abstract Children with cerebral palsy who walk with knee flexion during midstance are treated with intramuscular injections of botulinum toxin A (BTX-A) to prevent them from potential deterioration and to improve their mobility. ...

» Botulinum toxin A and upper limb functional skills in hemiparetic cerebral palsy: a randomized trial in children receiving intensive therapy: Speth LAWM et al.

The objective of this study was to determine whether the useof intramuscular botulinum toxin A (BTX-A) increases upper limb function and skills in the context of a specific therapy programme in children with hemiparetic cerebralpalsy. ...

» Does Botulinum Toxin A Combined with Bracing Prevent Hip Displacement in Children with Cerebral Palsy and “Hips at Risk”? A Randomized, Controlled Trial: Graham HK et al.

Background: Cerebral palsy is the most common cause of childhood physical disability in developed countries, affecting two children per 1000 live births. ...

» Modification of altered ankle motor control after stroke using focal application of Botulinum toxin type A: Tang SF et al.

Study design: Blinded, placebo-controlled, prospective clinical trial. ...

» Combining botulinum toxin and phenol to manage spasticity in children: Gooch JL et al.

Objective: To describe the specific techniques and adverse reactions of using concurrent, multiple injections of both botulinum toxin and phenol to manage spasticity in children with cerebral palsy (CP) and other neurologic conditions. ...

» The effectiveness of therapy on outcome following (BoNT-A) injection for focal spasticity in adults with neurological conditions: A systematic review: Moore EJ et al.

Objective: To determine the independent effectiveness of adjunctive therapies when provided in conjunction with botulinum neurotoxin (BoNT-A) injection for focal spasticity in adults with eurological conditions. ...

» Determining the technical and clinical factors associated with pain for children undergoing botulinum toxin injections under nitrous oxide and anesthetic cream: Brochard S et al.

Aims: To determine technical and clinical factors associated with pain when using ananalgesic protocol with 50% nitrous oxide/oxygen and anesthetic cream (lidocaine andprilocaine, Emla) for children with cerebral palsy undergoing botulinum toxin injections. ...

» Does Spasticity Reduction by Botulinum Toxin Type A Improve Upper Limb Functionality in Adult Post-Stroke Patients? A Systematic Review of Relevant Studies: Intiso D et al.

Objective: Botulinum toxin type A (BTX-A) use reduces upper limb (UL) spasticity in stroke patients, but the effects on functional recovery remain uncertain. The aim of present review was to as certain if the reduction of spasticity by use of BTX-A was linked to a functional gain of UL or in activity of daily living in post-stroke patients. ...

» Use of intrathecal baclofen therapy in ambulant children and adolescents with spasticity and dystonia of cerebral origin: a systematic review: Pin TW et al.

AIM: Studies on the use of intrathecal baclofen (ITB)for ambulant adults with spasticity and ⁄ or dystonia of cerebral origin are scarce, and are even more limited for children and adolescents. This systematic review investigates the use of ITB to improve walking, transfer ability, and gross motor activities in ambulant children and adolescents with spasticity and ⁄ or dystonia of cerebral origin. ...

» Τreatment of spasticity and functional οutcome after botulinum toxin A (Botox®) injection in patients with neurologic lesions: Dionyssiotis Y et al.

Purpose: The aim of this study was to investigate whether the consequences of neurologic lesions are underestimated when the Barthel Index (BI) is used to assess the clinical outcome of botulinum toxin injection. ...

» Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial: Thorley M et al.

Background: Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. ...

» Spasticity after stroke: Physiology, assessment and treatment: Thibaut A et al.

Background: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. ...

» Spasticity and Its Contribution to Hypertonia in Cerebral Palsy: Bar-On L et al.

Spasticity is considered an important neural contributor to muscle hypertonia in children with cerebral palsy (CP). ...

» Botulinum toxin use in neuro-rehabilitation to treat obstetrical plexus palsy and sialorrhea following neurological diseases: A review: Intiso D and Basciani M

Abstract: In neuro-rehabilitation, botulinum toxin (BTX) as adjunct to other interventions can result in a useful therapeutictool treating disabled people. ...

» Spasticity treatment with onabotulinumtoxin A: data from a prospective German real-life patient registry: Schramm A et al.

Abstract: This study aimed at providing real-life baseline, injection and outcome data for the treatment of various forms of spasticity with onabotulinumtoxin A in Germany. ...

» International consensus statement for the use of botulinum toxintreatment in adults and children with neurological impairments – introduction: Esquenazi A et al.

Introduction: People with neurological conditions such as stroke,cerebral palsy, cervical dystonia, Parkinson's disease, Motor Neurone Disease, Multiple Sclerosis and brain injury experience many impairments, including sensorimotor disorders, that limit their activities, participation and quality of life. ...

» Botulinum Toxin for Spasticity in Children With Cerebral Palsy: A Comprehensive Evaluation: Bjornson K et al.

Abstract BACKGROUND — Spasticity is a prevalent disabling clinical symptom for children with cerebral palsy. Treatment of spasticity with botulinum toxin in children with cerebral palsy was first reported in 1993. Botulinum toxin provides a focal, controlled muscle weakness with reduction in spasticity. Interpretation of the literature is difficult due to the paucity of reliable measures of spasticity and challenges with measuring meaningful functional changes in children with disabilities ...

» Comparative assessment of therapeutic response to physiotherapy with or without botulinum toxin injection using diffusion tensor tractography and clinical scores in term diplegic cerebral palsy children: Chaturvedi SK et al.

Abstract: The present study was to compare the effects of combined therapy [botulinum (BTX) plus physiotherapy] with physiotherapy alone using diffusion tensor imaging (DTI) derived fractional anisotropy (FA) values of motor and sensory fiber bundles and clinical grade of the disability to see the value of BTX in term children with spastic diplegic cerebral palsy (CP). ...

» The orthotic and therapeutic effects following daily community applied functional electrical stimulation in children with unilateral spastic cerebral palsy: a randomised controlled trial: Pool D et al.

Abstract Background: The purpose of this study was to determine the orthotic and therapeutic effects of daily communityapplied FES to the ankle dorsiflexors in a randomized controlled trial. We hypothesized that children receiving theeight-week FES treatment would demonstrate orthotic and therapeutic effects in gait and spasticity as well as better community mobility and balance skills compared to controls not receiving FES. ...

» Cost-Utility Analysis of Incobotulinumtoxin-A Compared With Conventional Therapy in the Management of Post-Stroke Spasticity in Romania: Turcu-Stiolica A et al.

Objectives: In Romania, the strokes’ incidence is of 61,500 per year and improving upper limb function is the essence in rehabilitation after a stroke to maximize the patient quality of life and reduce disability. ...

» Botulinum toxin for the management of adult patients with upper motor neuron syndrome: Esquenazi A et al.

Abstract: The upper motor neuron (UMN) syndrome is a collection of interactive positive signs (associated with spastic hypertonia) and negative signs, such as muscle weakness and lossof voluntary control. ...

» Botulinum toxin injection into the forearm muscles for wrist and fingers spastic overactivity in adults with chronic stroke: a randomized controlled trial comparing three injection techniques: Picelli A et al.

Abstract Objective: To compare the outcome of manual needle placement, electrical stimulation and ultrasonography-guided techniques for botulinum toxin injection into the forearm muscles of adults with arm spasticity. ...

» USE OF BOTULINUM TOXIN TYPE A IN THE TREATMENT OF SPASTICITY IN CHILDREN WITH CEREBRAL PALSY: Lazić L et al.

Cerebral palsy has an incidence of about 1-2 per 1000 live births, and in spite of the progress of neonatal medicine, it seems that the incidence will not subside in the near future. ...

» Review article Botulinum toxins in the treatment of primary focal dystonias: Truong D

Abstract: Focal dystonia, such as cervical dystonia, blepharospasm, oromandibular dystonia, largyngeal dystonia, and limb dystonia, is often observed in adult-onset primary dystonia syndromes that affect a specific area of the body and tend to have little or no spread. This review will examine the past, present, and future ap-proaches to the treatment of focal dystonia. ...

» A systematic review of interventions for children with cerebralpalsy: state of the evidence: Novak I et al.

AIM: The aim of this study was to describe systematically the best available intervention evidence for children with cerebral palsy (CP). ...

» Musculoskeletal ultrasound for interventional physiatry: De Muynck M et al.

More and more physiatrists are interested in learning how to use musculoskeletal ultrasonography in their clinical practice. ...

» The Use of Computerised Dynamometry to Quantify Functional Grip and Release in People Post Stroke: A Pilot Study: Baguley IJ et al.

Abstract: Purpose: To present a theoretical construct and pilot data from an analytic technique to simultaneously quantify positive and negative upper motor neuron (UMN) features. ...

» A French observational study of botulinum toxin use in the management of children with cerebral palsy: BOTULOSCOPE: Chale´at-Valayer E et al.

Abstract: Background: Dystonia and spasticity are common symptoms in children with Cerebral Palsy (CP), whose management is a challenge to overcome in order to enable the harmonized development of motor function during growth. ...

» Goal attainment following upper-limb botulinum toxin-A injections: are we facilitating achievement of client-centred goals?: Nott MT et al.

Objectives: Evaluate upper-limb goal attainment following botulinum toxin-A, map goals to the International Classification of Functioning, Disability and Health (ICF) and explore associations between client goals, clinical indicators of spasticity and the Botulinum Toxin-A injection strategy adopted by the treating physician. ...

» Evidence-based review and assessment of botulinum neurotoxin for the treatment of adult spasticity in the upper motor neuron syndrome: Esquenazi A et al.

Abstract: Botulinum neurotoxin (BoNT) can be injected to achieve therapeutic benefit across a large range of clinical conditions. ...

» Botulinum toxin treatment in neurological practice: how much does it really cost? A prospective cost-effectiveness study: Burbaud B et al.

Abstract: Botulinum toxin (BTA) is a safe and effective therapeutic tool for many neurological conditions but few studies have investigated its real cost in neurological practice. ...

» Effects of early spasticity treatment onchildren with hemiplegic cerebral palsy: a preliminary study: Bueno Zonta M et al.

ABSTRACT Objective: To compare motor and functional performance of two groups of children with hemiplegic cerebral palsy (HCP). Only the studygroup (SG) received early treatment of spasticity with botulinum neurotoxin type A (BXT-A). ... RESUMO Objetivo: Comparar a performance motora e funcional de dois grupos de crianças com paralisia cerebral hemiplégica (PCH). ...

» Botulinum toxin use in neuro-rehabilitation to treat obstetrical plexus palsy and sialorrhea following neurological diseases: A review: Intiso D and Basciani M

Abstract: In neuro-rehabilitation, botulinum toxin (BTX) as adjunct to other interventions can result in a useful therapeutictool treating disabled people. ...

» Intensive therapy following upper limb botulinum toxin Ainjection in young children with unilateral cerebral palsy:a randomized trial: Hoare B et al.

AIM: Botulinum toxin A (BoNT-A) combined with occupational therapy is effective inimproving upper limb outcomes in children with unilateral cerebral palsy (CP). ...

» GRIN: “ GRoup versus INdividual physiotherapy following lower limb intra-muscular Botulinum Toxin-A injections for ambulant children with cerebral palsy: an assessor-masked randomisedcomparison trial” : study protocols: A review: Thomas RE et al.

Abstract Background: Cerebral palsy is the most common cause of physical disability in childhood. ...

» Botulinum toxin type A combined with neurodynamic mobilization for lower limb spasticity: a case report: Villafañe JH

Abstract Objective: This case report describes a patient with severe lower limb spasticity treated with botulinum toxin type A (BoNT-A) and neurodynamic mobilization (NM). ...

» Botulinum Toxin Injections or Application of Splints: Impact on Spasticity, Range of Motion and Function of Upper Extremity in Chronic Stroke Patients: Shamili A et al.

ABSTRACT: Spasticity or increase in muscle tone is one of the problems following stroke. Due to this increase inmuscle tone, patients are confronted to problems in motor control and difficulties in activities of daily livingand complications such as shortness and contracture. ...

» Management of Spasticity and Cerebral Palsy: Awaad Y et al.

1. Introduction: Spasticity was defined by Lance as a "velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex" (Young RR, 1994; Francisco GE, Ivanhoe CB, 1997). ...

» Clinical and pharmacological properties ofincobotulinumtoxin A and its use in neurological disorders: Jost WH et al.

Background: IncobotulinumtoxinA (Xeomin®) is a purified botulinum neurotoxin type A formulation, free from complexing proteins, with proven efficacy and good tolerability for the treatment of neurological conditions such as blepharospasm, cervical dystonia (CD), and post-stroke spasticity of the upper limb. ...

» Rehabilitation Therapies AfterBotulinum Toxin-A Injection toManage Limb Spasticity:A Systematic Review: Kinnear BZ et al.

Background: Botulinum toxin A (BoNT-A) injections are increasingly used to treat muscle spasticity and are often complemented by adjunctive rehabilitation therapies; however, little is known about the effect of therapy after injection. ...

» Combined Passive Stretchingand Active Movement Rehabilitation of Lower-Limb Impairments in Children With Cerebral Palsy – Using a Portable Robot: Wu Y-N et al.

Abstract Background: Ankle impairments are closely associated with functional limitations in children with cerebral palsy (CP). Passive stretching is often used to increase the range of motion (ROM) of the impaired ankle. Improving motor controlis also a focus of physical therapy. ...

» Review Article Shock Waves in the Treatment of Muscle Hypertonia and Dystonia: Mori L et al.

1. Introduction Muscle hypertonia is a common finnding in patients withupper motor neuron syndrome (UMNS) ollowing stroke, multiple sclerosis, spinal cord injury, and traumatic braininjury. ...

» Review Article – Spasticity and Its Contribution to Hypertonia in Cerebral Palsy: Bar-On L et al.

1. Introduction Muscle tone regulation helps to maintain normal posture and to facilitate movement [1]. ...

» A Double-Blind, Randomised, Crossover Trial of Two Botulinum Toxin Type A in Patients with Spasticity: Guarany FC et al.

Introduction: Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflex [1] that might cause painand disability [2,3]. ...

» Extracorporeal Shock Wave Therapy forthe Treatment of Poststroke Plantar-Flexor Muscles Spasticity: A Prospective Open-Label Study: Santamato A et al.

Objectives: To assess the use of extracorporeal shock wave therapy (ESWT) for the treatment of equinus foot after stroke and to correlate the ESWT effect on spastic plantar-flexor muscles with echo intensity on the Heckmatt scale. ...

» Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity: Willerslev-Olsen M et al.

AIM Clinical determination of spasticity is confounded by the difficulty in distinguishingreflex from passive contributions to muscle stiffness. ...

» Meta-Analysis of Neutralizing Antibody Conversion with OnabotulinumtoxinA (BOTOX®) Across Multiple Indications: Naumann M et al.

Abstract: This meta-analysis evaluated the frequency of neutralizing antibody (nAb) conversion with onabotulinumtoxinA (BOTOX®; Allergan) across five studied indications. ...

» IncobotulinumtoxinA (Xeomin®) injected for blepharospasm or cervical dystonia according to patient needs is well tolerated: Evidente VGH et al.

Abstract: Typically, botulinum toxin injections for blepharospasm or cervical dystonia (CD) are administered at approxi-mately 3-month intervals, reflecting concerns that shorter intervals might increase the risk of adverseevents (AEs) and development of neutralizing antibodies. ...

» Efficacy and Safety of IncobotulinumtoxinA (NT 201, Xeomin) in theTreatment of Blepharospasm—A Randomized Trial: Jankovic J et al.

Abstract: IncobotulinumtoxinA (NT 201, Xeomin) is a highly purified botulinum neurotoxin type A formulation, free from complexing proteins. ...

» Sustained efficacy and safety of repeated incobotulinumtoxinA (Xeomin®) injections in blepharospasm: Truong D et al.

Abstract: IncobotulinumtoxinA (Xeomin®, NT 201) is a purified botulinum toxin type A free from accessory (complexing) proteins. ...

» Botulinum Toxin Treatment of Neuropathic Pain: Om Mitta S et al.

Abstract: Neuropathic pain (NP), a common form of human pain, often poorly responds to analgesic medications. ...

» Efficacy of botulinum toxin type A for treatment of persistent myofascial TMD pain: A randomized, controlled, double-blind multicenter study: Ernberg M et al.

Abstract: Evidence of an effect by botulinum toxins is still lacking for most pain conditions. ...

» Botulinum Toxin in Parkinson Disease Tremor: A Randomized, Double-Blind, Placebo-Controlled Study With a Customized Injection Approach: Om Mitta S et al.

Background: In essential tremor and Parkinson disease (PD) tremor, administration of onabotulinumtoxinA via a fixed injection approach improves the tremor, but many patients (30%-70%) develop moderate to severe hand weakness, limiting the use of onabotulinumtoxinA in clinical practice. ...

» Botulinum Toxin in Restless Legs Syndrome—A Randomized Double-Blind Placebo-Controlled Crossover Study: Om Mitta S et al.

Abstract: Background: Restless Legs Syndrome (RLS) is a common movement disorder with an estimated prevalence of up to 12%. ...

Publications of IAB Experts

» Adib Saberi, Fereshte MD, PhD

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» Altenmueller, Professor Eckart MD, PhD, MA

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» Bein-Wierzbinski, Wibke, PhD

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» Braehler, Gabriele

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» Frevert, Dr. rer. nat. Juergen, BSc

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» Klietz, Martin, PhD

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» Montecucco, Prof. Cesare

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» Pickenbrock, Heidrun, Dr. rer. biol. hum., MSc

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Reference Books

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Books of very experienced experts can be of tremendous benefit to therapists, but also to interested patients alike. A selection of reference books for patients and relatives as well as for physicians and health professionals are compiled here and offered for sale

Rating Scales

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The success of a complex therapy of chronic conditions with several therapists involved is decisively determined by the exact documentation of the processes and their effect. This documentation is in the hands of the patient between visits to the physician. IAB selects, produces and sells ratings scales for movement disorders and therapy effects. Some are […]

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Movement Disorders bear some of the most intriguing mysteries yet to discover. Our recorded experts are among the best known scientists working on these topics being right in the centre of it all. who could better answer our questions as? IAB produces videos with internationally outstanding scientists on the subject of movement disorders of great historical value.