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Related Concept Videos

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...

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Related Experiment Video

Updated: May 23, 2026

Enhancing Upper Limb Function and Motor Skills Post-Stroke Through an Upper Limb Rehabilitation Robot
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Published on: September 6, 2024

Can botulinum toxin decrease carer burden in long term care residents with upper limb spasticity? A randomized

Kuen Lam1, Kwok Kwong Lau, Kar Kui So

  • 1Cheshire Home, Shatin, Hong Kong. lam_kuen@yahoo.com.hk

Journal of the American Medical Directors Association
|April 24, 2012
PubMed
Summary

Botulinum toxin injections significantly reduced caregiver burden in long term care patients with severe upper limb spasticity. This treatment also improved patient-centered outcomes and spasticity measures.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Geriatrics

Background:

  • Severe upper limb spasticity poses challenges for long-term care patients.
  • Caregiver burden is a significant concern in managing these patients.

Purpose of the Study:

  • To assess the efficacy of botulinum toxin A in alleviating caregiver burden for patients with severe upper limb spasticity.
  • To evaluate the impact of botulinum toxin A on patient-centered outcomes and spasticity.

Main Methods:

  • A double-blind, placebo-controlled trial involving 55 long-term care patients with upper limb spasticity.
  • Patients received either intramuscular botulinum toxin A or saline, with assessments over a 24-week period.
  • Primary outcome: caregiver burden scale. Secondary outcomes: goal attainment, spasticity (Modified Ashworth Score), range of motion, and pain.

Main Results:

  • Botulinum toxin A significantly reduced caregiver burden by week 6 (60% vs. 8%, P < .001), an effect sustained to week 24.
  • Improvements were observed in goal attainment, spasticity, and passive range of motion for shoulder, elbow, and fingers.
  • No significant difference in pain scores; no serious adverse effects reported.

Conclusions:

  • Intramuscular botulinum toxin A injections are effective in reducing caregiver burden for long-term care patients with upper limb spasticity.
  • The treatment also leads to improvements in patient-centered outcome measures and spasticity.
  • Botulinum toxin A offers a beneficial therapeutic option for this patient population.