Trial reportJournal of neuroengineering and rehabilitation2025
Combined effects and timing of robotic training and botulinum toxin on upper limb spasticity and motor function: a single‑blinded randomized controlled pilot study.
Trial report in Journal of neuroengineering and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02228863 (Upper Extremity Rehabilitation Using Robot and Botulinum Toxin), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Upper Extremity Rehabilitation Using Robot and Botulinum Toxin
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Botulinum Toxin Combined with Robot-Assisted Therapy for Post-Stroke Spasticity: A Systematic Review.Toxins · 2025Pooled it
- Botulinum toxin A combining with robot-assisted bimanual therapy integrating mirror therapy versus botulinum toxin A combining with robot-assisted bimanual therapy in patients with post-stroke spastic fingers: a randomized controlled pilot trial.Journal of neuroengineering and rehabilitation · 2025Trial
- Pulsed Radiofrequency for Post-Stroke Complications: From Neuromodulation to Functional Recovery.Current neurology and neuroscience reports · 2026Review
- Non-Invasive Assessment of Hypertonic Muscle Properties After Botulinum Toxin Neuromodulation in Post-Stroke Patients: A Systematic Literature Review of Recent Evidence (2023-2025) on Mobility and Balance.Life (Basel, Switzerland) · 2026Review
- Review
- Robot-Assisted Mirror Therapy for Upper Limb and Hand Recovery After Stroke: Clinical Efficacy and Insights into Neural Mechanisms.Journal of clinical medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundThis study aimed to evaluate the combined effects of robotic training (RT) and botulinum toxin (BTX) injections on motor function and spasticity in individuals with post-stroke upper limb spasticity (ULS). We also sought to investigate the optimal timing of RT and BTX administration.
methodsForty-two participants with chronic stroke-induced ULS were initially enrolled and randomized into four groups: Group B4R4 (RT + BTX at 4 weeks [W4]), Group B0R0 (RT + BTX at baseline [W0]), Group B0R4 (BTX at W0, RT at W4), and Group B4R0 (RT at W0, BTX at W4). Clinical assessments and robotic kinematic evaluations were performed at W0, W4, and 8 weeks (W8). The primary outcome was the Fugl-Meyer assessment (FMA) score, and secondary outcomes included the modified Ashworth scale (MAS) of the elbow and kinematic parameters, such as spectral arc length, mean speed, hand path ratio, and movement deviation in various tasks. Changes in outcome measures over time were analyzed using a linear mixed-effects regression model or ordinal logistic regression.
resultsOf the 42 participants, 40 completed the study. From W0 to W4, Group B0R0 exhibited the most favorable outcomes in terms of spasticity (MAS-elbow flexor and extensor) and kinematic variables, suggesting that the combined application of BTX and RT is superior to sole interventions in improving motor function and spasticity. From W0 to W8, Group B0R4 demonstrated the most substantial improvements in FMA scores and kinematic parameters, indicating that the combined use of BTX and RT, particularly when RT is initiated 1 month after BTX injection, results in superior functional outcomes compared to other intervention timings.
conclusionsThe combination of RT and BTX is more effective in enhancing motor function and reducing spasticity in individuals with ULS than either intervention alone or no intervention. Furthermore, the timing of RT relative to BTX injection plays a critical role in maximizing therapeutic benefits in individuals with stroke and ULS, given the distinct modes of action of each intervention.
trial registrationclinicaltrials.gov NCT02228863. The study was retrospectively registered on August 23, 2014.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.