{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:51:09Z","timestamp":1747151469512,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011199","name":"FP7 Ideas: European Research Council","doi-asserted-by":"publisher","award":["291339"],"award-info":[{"award-number":["291339"]}],"id":[{"id":"10.13039\/100011199","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001254","name":"Ipsen Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001254","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["104003008"],"award-info":[{"award-number":["104003008"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Botulinum toxin\u2010A (BoNT) is widely used to manage focal upper limb spasticity and is effective in reducing resistance to passive movement, as measured with the modified Ashworth scale. Discrimination and quantification of the underlying neural and non\u2010neural components of hyper\u2010resistance may further improve understanding of the effect of BoNT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the effects of BoNT on neural (NC), non\u2010neural elastic (EC), and viscous (VC) components of resistance to passive wrist extension in adults with stroke or cerebral palsy and the association between the effects on wrist hyper\u2010resistance components and clinical spasticity, pain and motor function scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Pre\u2010experimental study with pre\u2010 and post\u2010intervention measurements at 6 and 12\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>An outpatient clinic of a hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adults with chronic stroke or cerebral palsy indicated for BoNT treatment for hyper\u2010resistance in the wrist (N\u2009=\u200918).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>BoNT injections in the wrist and\/or finger flexor muscles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Wrist hyper\u2010resistance components, using the NeuroFlexor, and clinical scales (modified Ashworth scale, Tardieu scale, passive wrist extension, pain, Fugl\u2010Meyer motor assessment of the upper extremity, and action research arm test).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>NC was significantly reduced 6 and 12\u2009weeks post\u2010intervention (median\u2009\u221211.96 Newton, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001 and median \u22129.34 Newton, <jats:italic>P<\/jats:italic>\u2009=\u2009.001, respectively); non\u2010neural EC and VC showed no change. NC reduction 6\u2009weeks post\u2010intervention correlated significantly with BoNT dose (Pearson correlation coefficient <jats:italic>r<\/jats:italic><jats:sub>p<\/jats:sub>\u2009=\u2009\u22120.56). No significant correlations were found between change scores in wrist hyper\u2010resistance components and clinical scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BoNT affected the neural component of resistance to passive wrist extension, while leaving the non\u2010neural elastic and viscous components unaffected. This instrumented approach to quantify the effects of BoNT in the wrist and finger flexor muscles on the components of wrist hyper\u2010resistance may have an added value for BoNT treatment evaluation in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12602","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T06:37:41Z","timestamp":1617431861000},"page":"486-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The effect of botulinum <scp>toxin\u2010A<\/scp> on neural and non\u2010neural components of wrist hyper\u2010resistance in adults with stroke or cerebral palsy"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0707-2966","authenticated-orcid":false,"given":"Aukje","family":"Andringa","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience Amsterdam 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