{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:24:39Z","timestamp":1773285879176,"version":"3.50.1"},"reference-count":123,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:00:00Z","timestamp":1723075200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Andrew Dobbyn and Stephanie Margolin Scholarship from the Epworth Medical Foundation"},{"name":"Physiotherapy Research at Epworth Rehabilitation (PrOsPER) Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Botulinum neurotoxin-A (BoNT-A) injections are effective for focal spasticity. However, the impact on muscle strength is not established. This study aimed to investigate the effect of BoNT-A injections on muscle strength in adult neurological conditions. Studies were included if they were Randomised Controlled Trials (RCTs), non-RCTs, or cohort studies (n \u2265 10) involving participants \u226518 years old receiving BoNT-A injection for spasticity in their upper and\/or lower limbs. Eight databases (CINAHL, Cochrane, EMBASE, Google Scholar, Medline, PEDro, Pubmed, Web of Science) were searched in March 2024. The methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the Prospective Register of Systematic Reviews (PROSPERO: CRD42022315241). Quality was assessed using the modified Downs and Black checklist and the PEDro scale. Pre-\/post-injection agonist, antagonist, and global strength outcomes at short-, medium-, and long-term time points were extracted for analysis. Following duplicate removal, 8536 studies were identified; 54 met the inclusion criteria (3176 participants) and were rated as fair-quality. Twenty studies were analysed as they reported muscle strength specific to the muscle injected. No change in agonist strength after BoNT-A injection was reported in 74% of the results. Most studies\u2019 outcomes were within six weeks post-injection, with few long-term results (i.e., &gt;three months). Overall, the impact of BoNT-A on muscle strength remains inconclusive.<\/jats:p>","DOI":"10.3390\/toxins16080347","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T12:13:14Z","timestamp":1723119194000},"page":"347","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Effect of Botulinum Neurotoxin-A (BoNT-A) on Muscle Strength in Adult-Onset Neurological Conditions with Focal Muscle Spasticity: A Systematic Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6577-3256","authenticated-orcid":false,"given":"Ren\u00e9e","family":"Gill","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Epworth Rehabilitation Epworth Healthcare Richmond, Melbourne 3121, Australia"},{"name":"School of Physiotherapy, The University of Melbourne, Parkville, Melbourne 3000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Banky","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Epworth Rehabilitation Epworth Healthcare Richmond, Melbourne 3121, Australia"},{"name":"School of Physiotherapy, The University of Melbourne, Parkville, Melbourne 3000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zonghan","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, The University of Melbourne, Parkville, Melbourne 3000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Medina Mena","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Epworth Rehabilitation Epworth Healthcare Richmond, Melbourne 3121, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi Ching Angie","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Epworth Rehabilitation Epworth Healthcare Richmond, Melbourne 3121, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Bryant","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, The University of Melbourne, Parkville, Melbourne 3000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7069-1191","authenticated-orcid":false,"given":"John","family":"Olver","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Epworth Rehabilitation Epworth Healthcare Richmond, Melbourne 3121, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Epworth Rehabilitation Epworth Healthcare Richmond, Melbourne 3121, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Epworth Rehabilitation Epworth Healthcare Richmond, Melbourne 3121, Australia"},{"name":"School of Physiotherapy, The University of Melbourne, Parkville, Melbourne 3000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1191\/1352458504ms1085oa","article-title":"Prevalence and treatment of spasticity reported by multiple sclerosis patients","volume":"10","author":"Rizzo","year":"2004","journal-title":"Mult. 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