{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:39:06Z","timestamp":1791545946332,"version":"4.3.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,10,11]],"date-time":"2020-10-11T00:00:00Z","timestamp":1602374400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PB-PG-0808-16319"],"award-info":[{"award-number":["PB-PG-0808-16319"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Does early treatment of spasticity with botulinum-toxin (BoNTA), in (hyper)acute stroke patients without arm-function, reduce contractures and improve function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Randomised placebo-controlled-trial<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Specialised stroke-unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants &amp; Intervention:<\/jats:title>\n                    <jats:p>Patients with an Action Research Arm Test (ARAT) grasp-score\u2a7d2 who developed spasticity within six-weeks of a first stroke were randomised to receive injections of: 0.9%sodium-chloride solution (placebo) or onabotulinumtoxin-A (treatment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome-Measures:<\/jats:title>\n                    <jats:p>Spasticity, contractures, splint use and arm function (ARAT) were taken at baseline, 12-weeks post-injection and six-months after stroke. Additionally, spasticity and contractures were measured at weeks-two, four and six post-injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Ninety three patients were randomised. Mean time to intervention was 18-days (standard deviation = 9.3). Spasticity was lower in the treatment group with difference being significant between week-2 to 12 (elbow) and week-2 to 6 (wrist). Mean-difference (MD) varied between \u20138.5(95% CI \u201317 to 0) to \u20139.4(95% CI \u201314 to \u20135) \u00b5V. Contracture formation was slower in the treatment group. Passive range of motion was higher in the treatment group and was significant at week-12 (elbow MD6.6 (95% CI \u20130.7 to \u201312.6)) and week-6 (wrist MD11.8 (95% CI 3.8 to 19.8)). The use of splints was lower in the treatment group odds ratio was 7.2 (95% CI 1.5 to 34.1) and 4.2 (95% CI 1.3 to 14.0) at week-12 and month-6 respectively. Arm-function was not significantly different between the groups MD2.4 (95% CI \u20135.3 to 10.1) and 2.9 (95% CI \u20135.8 to 11.6) at week-12 and month-6 respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>BoNTA reduced spasticity and contractures after stroke and effects lasted for approximately 12-weeks. BoNTA reduced the need for concomitant contracture treatment and did not interfere with recovery of arm function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration:<\/jats:title>\n                    <jats:p>EudraCT (2010-021257-39) and ClinicalTrials.gov-Identifier: NCT01882556.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0269215520963855","type":"journal-article","created":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T04:47:41Z","timestamp":1602478061000},"page":"399-409","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":59,"title":["Can the early use of botulinum toxin in post stroke spasticity reduce contracture development? A randomised controlled trial"],"prefix":"10.1177","volume":"35","author":[{"given":"Cameron","family":"Lindsay","sequence":"first","affiliation":[{"name":"School of Allied Health Professions, Keele University, Staffordshire, UK"},{"name":"Ulster Hospital, South Eastern HSC Trust, Belfast"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sissi","family":"Ispoglou","sequence":"additional","affiliation":[{"name":"Department of Elderly Medicine, Sandwell Hospital, West Bromwich, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brinton","family":"Helliwell","sequence":"additional","affiliation":[{"name":"Ulster Hospital, South Eastern HSC Trust, Belfast"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Hicklin","sequence":"additional","affiliation":[{"name":"Department of Elderly Medicine, Sandwell Hospital, West Bromwich, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Sturman","sequence":"additional","affiliation":[{"name":"Neurology Department, Queen Elizabeth Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2180-197X","authenticated-orcid":false,"given":"Anand","family":"Pandyan","sequence":"additional","affiliation":[{"name":"School of Allied Health Professions, Keele University, Staffordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,10,11]]},"reference":[{"key":"bibr1-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1177\/1545968314562115"},{"key":"bibr2-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1080\/09638280500535165"},{"key":"bibr3-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1191\/0269215503cr587oa"},{"key":"bibr4-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1177\/0269215510381620"},{"key":"bibr5-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1080\/09638280400014576"},{"key":"bibr6-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1177\/0269215508095089"},{"key":"bibr7-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000251722.77088.12"},{"key":"bibr8-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1016\/S1836-9553(12)70071-1"},{"key":"bibr9-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1177\/0269215512464502"},{"key":"bibr10-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-15-12"},{"key":"bibr11-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1097\/00004356-198112000-00001"},{"key":"bibr12-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(01)00084-5"},{"key":"bibr13-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1177\/0269215509358945"},{"key":"bibr14-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1984.sp015116"},{"key":"bibr15-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.6.3200"},{"key":"bibr16-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.159657"},{"key":"bibr17-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-011-2798-5"},{"issue":"10","key":"bibr18-0269215520963855","first-page":"CD010362","volume":"10","author":"Lindsay C","year":"2016","journal-title":"Cochrane Database of Syst Rev"},{"key":"bibr19-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1177\/1545968311430824"},{"key":"bibr20-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1177\/0269215511421355"},{"key":"bibr21-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.177071"},{"key":"bibr22-0269215520963855","first-page":"343","volume":"138","author":"Williams PE","year":"1984","journal-title":"J Anat"},{"key":"bibr23-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90107-0"},{"key":"bibr24-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws146"},{"key":"bibr25-0269215520963855","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030262"}],"container-title":["Clinical Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269215520963855","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0269215520963855","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269215520963855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:55:03Z","timestamp":1777395303000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0269215520963855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,11]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1177\/0269215520963855"],"URL":"https:\/\/doi.org\/10.1177\/0269215520963855","relation":{},"ISSN":["0269-2155","1477-0873"],"issn-type":[{"value":"0269-2155","type":"print"},{"value":"1477-0873","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,11]]}}}