Survivors of Stroke, Traumatic Brain Injury and/or Spinal Cord Injury Receive Broader Access to BOTOX® (botulinum toxin type A) injection for lower limb rehabilitation
Government subsidises BOTOX® injection for moderate to severe spasticity of the lower limb following an acute event1
Sydney, Australia: From 1 September, Australian survivors of acute events such as stroke, traumatic brain injury or spinal cord injury, suffering from involuntary muscle movements (spasticity) in their lower limbs, will now have broader access to BOTOX® (botulinum toxin type A) injection via the Pharmaceutical Benefits Scheme (PBS).
More than 475,000 Australians are living with the effects of stroke.2 Around one third (38%) of survivors will suffer spasticity within 12 months of their stroke.3Eight out of 10 (80%) of those with spinal cord injury will also have spasticity. 4
This new inclusion of BOTOX® injection on the PBS provides adults living with spasticity of the lower limb, following an acute event, with broader access to treatment to help support the management of their symptoms, quality of life and reduce the burden of disease.5
Spasticity resulting from injury to the central nervous system causes tightening or stiffness in muscles which can lead to jerking, twisting and involuntary contraction of the limbs, poor motor control, weakness and fatigue.6 The impact on patients and their carers is substantial.7 Spasticity is currently treated by a team of rehabilitation specialists including rehabilitation physicians or neurologists, allied health professionals and nurses.6
BOTOX® injection is administered as an intramuscular injection and contains the muscle relaxant obtained from the bacterium Clostridium botulinum.8It works by temporarily relaxing the overactive or contracting muscles.8
Professor John Olver, one of Australia's renowned rehabilitation Professors and Director of Rehabilitation, Mental Health and Chronic Pain Clinical Institute at the Epworth, welcomes the government's reimbursement of BOTOX® injection saying affordable access is very important to patients who may not be responding to standard treatments.
"There are thousands of Australians living with the effects of stroke, brain or spinal injury, many of whom are also dealing with spasticity.2Being able to do basic day-to-day tasks like wear shoes and socks correctly, go to the bathroom without assistance, or walk without pain, have the potential to make an enormous improvement to their quality of life," said Professor Olver.6
"Providing broader access to further treatment options is a critical commitment we need to make to this community living day to day with the devastation of neurological injury. We also need to consider the impact to their families and carers.7
"It's very important for anyone with focal spasticity of the lower limbs to seek the advice from their regular healthcare professional – their GP or physiotherapist who can consider referral to a rehabilitation physician or neurologist to discuss appropriate treatment options," added Professor Olver.6
"We commend the government for recognising the burden of lower limb spasticity on those who are already battling to recover from conditions like stroke and brain injury. It is imperative we ensure we make every proven approach available to give these patients every opportunity to maximise their rehabilitation and quality of life."
While BOTOX® (Botulinum toxin type A) treatment is more widely known as a cosmetic treatment, it is also available on the PBS for a number of medical conditions including:8,9
· Moderate to severe spasticity of the upper limb
· Eye twitching (blepharospasm)
· Limited movement of the ankle due to cerebral palsy (dynamic equinus foot deformity)
· Involuntary contraction of the neck muscles (spasmodic torticollis)
· Excessive sweating from the armpit area (severe primary axillary hyperhidrosis)
· Headaches occurring in adults with chronic migraine
· Bladder dysfunction (neurogenic detrusor overactivity)
· Overactive bladder (brought on spontaneously or from an unknown cause)
About BOTOX® Treatment
Treatment of lower limb spasticity should be tailored to each individual based on the size, number and location of muscles involved, the severity of spasticity, presence of local muscle weakness, and the patient's response to previous treatment.8 Clinical changes in muscle tone generally occurs within two weeks following treatment, with the peak effect seen in four to six weeks.8
Most side effects that have been reported in patients being treated with BOTOX® injection for focal spasticity were mild to moderate and got better without needing medical attention. Side effects reported include: pain in the affected limb, changes in ease of movement of the muscle, increased sensitivity to touch or pain, headache, muscular weakness, pain at the injection site, fever, flu-like illness, joint pain, swelling of the extremities such as the hands and feet and bruising under the skin.
Less common side effects include: weakness or a loss of energy, skin problems, nausea, 'pins & needles', itching, rash, pain and lack of coordination.10
