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Maldonado P, Bessaguet H, Chol C, Giraux P, Lafaie L, Adham A, David R, Celarier T, Ojardias E. Treatment of Acquired Deforming Hypertonia with Botulinum Toxin in Older Population: A Retrospective Study. Toxins (Basel) 2024; 16:365. [PMID: 39195775 PMCID: PMC11359055 DOI: 10.3390/toxins16080365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 08/29/2024] Open
Abstract
Acquired deforming hypertonia (ADH) affects the daily care of numerous nursing home residents. The aim of this study was to analyze the practice, aims, and effectiveness of botulinum toxin injections (BTxis) in the treatment of older patients with contractures, an indication for which BTxis are still underused. Data were extracted retrospectively from medical records regarding population, contractures, and injections. A prospective analysis was conducted to evaluate treatment goals set by goal attainment scaling (GAS) at T0 and at T1, to evaluate the therapeutic effects. We also recorded the occurrence of side effects, using a telephone questionnaire. This study included 41 patients older than 70 years who had received one or more BTxis for the first time between January 2018 and December 2021. Most of the older people we included lived in an institution (66%), manifested severe dependence, and presented significant morbi-mortality (37% of the patients died in the year after the last injection). The main objectives of these injections were purely comfort, without any functional goals. The GAS scores suggested effectiveness for comfort GAS scores. No complications were recorded. This study highlights the BTxis potential to address the needs of a larger number of older patients with ADH.
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Affiliation(s)
- Pablo Maldonado
- Department of Medical Gerontology, Gier Hospital, 19 rue Laurent Charles, 42400 Saint-Chamond, France;
| | - Hugo Bessaguet
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Inter-University Laboratory of Human Movement Biology, “Physical Ability and Fatigue in Health and Disease” Team (F-42023), Saint-Etienne “Jean Monnet”, “Lyon 1”, “Savoie Mont-Blanc” Universities, 42000 Saint-Etienne, France
| | - Cédric Chol
- Department of Medical Gerontology University Hospital of Saint Etienne (CHUSE), Charité Hospital, 44 Rue Pointe Cadet, 42100 Saint-Etienne, France; (C.C.); (L.L.); (T.C.)
| | - Pascal Giraux
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Lyon Neuroscience Research Center, Trajectoires Team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 and Saint-Etienne Universities), 42270 Saint-Etienne, France
| | - Ludovic Lafaie
- Department of Medical Gerontology University Hospital of Saint Etienne (CHUSE), Charité Hospital, 44 Rue Pointe Cadet, 42100 Saint-Etienne, France; (C.C.); (L.L.); (T.C.)
| | - Ahmed Adham
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Lyon Neuroscience Research Center, Trajectoires Team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 and Saint-Etienne Universities), 42270 Saint-Etienne, France
| | - Romain David
- Physical and Rehabilitation Medicine Unit, Poitiers University Hospital, University of Poitiers, 86021 Poitiers, France;
- PRISMATICS Laboratory (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Thomas Celarier
- Department of Medical Gerontology University Hospital of Saint Etienne (CHUSE), Charité Hospital, 44 Rue Pointe Cadet, 42100 Saint-Etienne, France; (C.C.); (L.L.); (T.C.)
| | - Etienne Ojardias
- Department of Physical Medicine and Rehabilitation, University Hospital of Saint Etienne (CHUSE), Bellevue Hospital, 25 Boulevard Pasteur, 42100 Saint-Etienne, France; (H.B.); (P.G.)
- Lyon Neuroscience Research Center, Trajectoires Team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 and Saint-Etienne Universities), 42270 Saint-Etienne, France
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