{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:05:20Z","timestamp":1770750320155,"version":"3.50.0"},"reference-count":22,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The objective of this review is to document the modalities to enhance the neuromuscular effects of botulinum toxin (BoNT) injection in spastic patients with multiple sclerosis (MS). Methods: We conducted a literature review focusing on studies involving BoNT administration for MS-related spasticity and the use of adjunctive therapies aimed at reducing dosage and increasing injection intervals. Results: The findings revealed a limited number of studies specific to MS patients, addressing only a few adjunct techniques, including electrical stimulation, vibration therapy, physical exercise, and extracorporeal shock wave therapy. Conclusions: These preliminary findings highlight the need for further research into integrative therapeutic strategies tailored specifically to the MS population.<\/jats:p>","DOI":"10.3390\/jcm14155252","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:11:44Z","timestamp":1753366304000},"page":"5252","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multiple Sclerosis: Enhancing Botulinum Toxin Effects in Spasticity Management, a Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4135-5695","authenticated-orcid":false,"given":"Daniela","family":"Poenaru","sequence":"first","affiliation":[{"name":"Rehabilitation Department, Carol Davila University of Medicine, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miruna Ioana","family":"Sandulescu","sequence":"additional","affiliation":[{"name":"Rehabilitation Department, Carol Davila University of Medicine, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalin","family":"Furculescu","sequence":"additional","affiliation":[{"name":"National Institute of Rehabilitation, 030167 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5801-5416","authenticated-orcid":false,"given":"Claudia Gabriela","family":"Potcovaru","sequence":"additional","affiliation":[{"name":"Rehabilitation Department, Carol Davila University of Medicine, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Makhoul, K., Ahdab, R., Riachi, N., Chalah, M.A., and Ayache, S.S. 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