Editorial: Emerging concepts and evidence in novel approaches for spasticity management

摘要

This research topic sheds light on recent advances in emerging theories and management of adult and pediatric spasticity. The examples are the hyaluronan hypothesis, dry needling, the hydro-dissection effect on spasticity, technology as non-invasive brain stimulation, peripheral magnetic or electrical stimulation, clinical and instrumental evaluations in spasticity, the precisions of injection, ergonomics during injection, dosage and dilution of botulinum toxin, phenol and alcohol, hyaluronidase, cryoneurolysis, surgical interventions, orthoses, and assistive devices, and even practical guidance for outpatient spasticity management during the coronavirus (covid-19) pandemic.Numerous breakthroughs and novel theories have emerged in the field of spasticity management; nevertheless, the absence of robust empirical data persists. Hence, the objective of this research topic is to present a comprehensive analysis of recent advancements and offer insights into the existing body of evidence relating to these advancements.A review [2]: The presence of spasticity in individuals with upper motor neuron problems often leads to severe joint abnormalities, which often require neuro-orthopedic surgical interventions. This study addresses a significant gap in the literature by doing a comprehensive evaluation of the effectiveness of therapies for spasticity in adult patients. A comprehensive search yielded a total of 80 pertinent researches, while 40 trial articles were thoroughly analyzed to identify intervention areas. A lack of randomized controlled trials was observed. Although the absence of standardized evaluation procedures poses a significant difficulty, this review effectively illustrates the indisputable beneficial effects of meticulously chosen surgical interventions on the quality of life for individuals suffering with upper limb spasticity. The necessity for unified methodologies and established protocols becomes crucial to promote evidence-based decision-making in surgical selections and patient referrals. Editorial perspectives: Access to surgical interventions varies widely by access to expert centres that offer treatment. It may be more accessible in countries that cannot afford botulinum toxins, yet inaccessible in many developed economies. This paper summarized the literature and serves as a review to launch more structured outcome based studies. [4]The future quality of evidences should be encourage as high rank as randomized trials without serious limitations, well-performed observational studies with vary large effects (or other qualifying factors), or even moderate rank as randomized trials with serious limitations, well-performed observational studies yielding large effects. [3] In addition, the outcome assessment is also need to consensus.Original research [5]: A thorough examination of a cohort of 68 individuals who were referred for inpatient rehabilitation within a six-month period following their initial occurrence of stroke According to the findings of the study, the patients, on average, underwent their initial phenol neurolysis for roughly 16.3 weeks, with the earliest being 19 days, and more than half of the patients for within 12 weeks of the occurrence of the stroke. The nerves most frequently targeted were the motor branches of the tibial and sciatic nerves. The early phenol neurolysis resulted in a significant reduction in the total amount of botulinum toxin (BoNT) required for the treatment of spasticity without any observed adverse effects. Editorial perspectives: There are very few studies that have examined the outcomes of phenol neurolysis [6]. There are even fewer prospective studies. This retrospective analysis highlights the need for prospective studies to further assess the contribution of phenol to spasticity care. The future research should explore the risk and benefit, short-term and long-term of phenol neurolysis. Additionally, the alcohol neurolysis [7] and the cryoneurolysis [8] are evidence