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Related Concept Videos

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

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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.
The binding of dantrolene to the RYR1...
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Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

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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...
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Classification of Skeletal Muscle Relaxants01:28

Classification of Skeletal Muscle Relaxants

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Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
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Peripherally and Centrally Acting Muscle Relaxants: A Comparison01:09

Peripherally and Centrally Acting Muscle Relaxants: A Comparison

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Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
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Centrally Acting Muscle Relaxants: Therapeutic Uses01:24

Centrally Acting Muscle Relaxants: Therapeutic Uses

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Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
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Spasmolytic Agents: Chemical Classification01:29

Spasmolytic Agents: Chemical Classification

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Spasmolytic agents are drugs used to alleviate muscle spasms and spasticity. They can be categorized into different chemical groups based on their mechanisms of action. Centrally acting spasmolytics primarily affect the spinal cord, while others directly target skeletal muscle cells.
A major class of centrally acting spasmolytics is the α2-agonist, such as tizanidine. These drugs bind to α2-adrenoceptors, inhibiting the release of the excitatory neurotransmitter glutamate. They also...
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  11. Botulinum Toxin A For Elbow Flexor Spasticity: A Non-randomized Observational Study Of Muscle-specific Injection Strategies.
  1. Home
  3. Research Domains
  5. Health Sciences
  7. Sports Science And Exercise
  9. Motor Control
  11. Botulinum Toxin A For Elbow Flexor Spasticity: A Non-randomized Observational Study Of Muscle-specific Injection Strategies.

Related Experiment Video

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
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Botulinum Toxin A for Elbow Flexor Spasticity: A Non-Randomized Observational Study of Muscle-Specific Injection Strategies.

Miruna Ioana Săndulescu1,2, Delia Cinteză3, Daniela Poenaru3

  • 1Doctoral School, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Journal of Clinical Medicine
|June 13, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Targeting specific elbow flexor muscles with botulinum toxin A (BoNT-A) injections can improve post-stroke spasticity. Combining brachialis and brachioradialis muscles yielded superior results for supination and motor control in patients.

Keywords:
botulinum toxinelbow flexorsneurorehabilitationpost-stroke spasticity

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Pharmacology

Background:

  • Elbow flexor spasticity is a common post-stroke complication affecting quality of life.
  • Botulinum toxin A (BoNT-A) injections are a potential treatment, but optimal muscle targeting is debated.
  • Understanding specific muscle group responses to BoNT-A is crucial for effective treatment.

Purpose of the Study:

  • To investigate the impact of different BoNT-A injection strategies on elbow flexor spasticity in post-stroke patients.
  • To compare the efficacy of targeting biceps brachii, brachialis, or brachialis plus brachioradialis muscles.
  • To assess improvements in spasticity, paresis, and active supination range of motion (ROM).

Main Methods:

  • A non-randomized observational study involving 52 post-stroke participants with upper limb spasticity (pattern IV).
  • Participants were grouped based on BoNT-A injection sites: biceps brachii (n=15), brachialis (n=9), or brachialis plus brachioradialis (n=28).
  • Spasticity and paresis angles, and active supination ROM were measured using the Tardieu Scale and goniometry at baseline and 4-week follow-up.

    • Main Results:

    • All groups showed trends towards decreased spasticity and improved motor control.
    • The brachialis plus brachioradialis group exhibited the most significant improvements in paresis angle and active supination ROM.
    • The biceps brachii group showed comparable paresis improvements but required higher doses and had the greatest effect on passive extension.

    Conclusions:

    • Individualized muscle selection for BoNT-A injections is critical for treating post-stroke elbow flexor spasticity.
    • Combining brachialis and brachioradialis injections offers superior benefits for supination and motor control.
    • This strategy is particularly advantageous for patients with significant elbow flexion and pronation post-stroke.