{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:38:52Z","timestamp":1791545932877,"version":"4.3.4"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>There is extensive literature supporting the efficacy of botulinum toxin (BoNT-A) for the treatment of post-stroke spasticity, however, there remain gaps in the routine management of patients with post-stroke spasticity. A panel of 21 Italian experts was selected to participate in this web-based survey Delphi process to provide guidance that can support clinicians in the decision-making process. There was a broad consensus among physicians that BoNT-A intervention should be administered as soon as the spasticity interferes with the patients\u2019 clinical condition. Patients monitoring is needed over time, a follow-up of 4\u20136 weeks is considered necessary. Furthermore, physicians agreed that treatment should be offered irrespective of the duration of the spasticity. The Delphi consensus also stressed the importance of patient-centered goals in order to satisfy the clinical needs of the patient regardless of time of onset or duration of spasticity. The findings arising from this Delphi process provide insights into the unmet needs in managing post-stroke spasticity from the clinician\u2019s perspective and provides guidance for physicians for the utilization of BoNT-A for the treatment of post-stroke spasticity in daily practice.<\/jats:p>","DOI":"10.3390\/toxins13040236","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T21:09:45Z","timestamp":1616706585000},"page":"236","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["BoNT-A for Post-Stroke Spasticity: Guidance on Unmet Clinical Needs from a Delphi Panel Approach"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8440-6283","authenticated-orcid":false,"given":"Alessio","family":"Baricich","sequence":"first","affiliation":[{"name":"Physical Medicine and Rehabilitation, Department of Health Sciences, Universit\u00e0 del Piemonte Orientale, viale Piazza d\u2019armi 1, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Wein","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 0G4, Canada"},{"name":"Department of Neurology and Neurosurgery, McGill University Health Center, Montreal, QC H4A 3J1, Canada"},{"name":"Division of Neurology, Stroke Prevention Clinic, Montreal General Hospital, 1650 Cedar Avenue, Montreal, QC H3G 1A4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-3290","authenticated-orcid":false,"given":"Nicoletta","family":"Cinone","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Spasticity and Movement Disorder Unit, Policlinico Riuniti, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, ASST Sette Laghi, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-8276","authenticated-orcid":false,"given":"Alessandro","family":"Picelli","sequence":"additional","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Study and Research Centre, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Chisari","sequence":"additional","affiliation":[{"name":"Unit of Neurorehabilitation, University Hospital of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Molteni","sequence":"additional","affiliation":[{"name":"Villa Beretta Rehabilitation Center, Valduce Hospital, Via Nazario Sauro 17, 23845 Costa Masnaga, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1452-8485","authenticated-orcid":false,"given":"Andrea","family":"Santamato","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Spasticity and Movement Disorder Unit, Policlinico Riuniti, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"key":"ref_1","first-page":"9","article-title":"New insights into the pathophysiology of post-stroke spasticity","volume":"10","author":"Li","year":"2015","journal-title":"Front. 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