{"id":"https://openalex.org/W1973178783","doi":"https://doi.org/10.3109/09638288.2013.791727","title":"Effectiveness of botulinum toxin injection with and without needle electromyographic guidance for the treatment of spasticity in hemiplegic patients: a randomized controlled trial","display_name":"Effectiveness of botulinum toxin injection with and without needle electromyographic guidance for the treatment of spasticity in hemiplegic patients: a randomized controlled trial","publication_year":2013,"publication_date":"2013-05-14","ids":{"openalex":"https://openalex.org/W1973178783","doi":"https://doi.org/10.3109/09638288.2013.791727","mag":"1973178783","pmid":"https://pubmed.ncbi.nlm.nih.gov/23672209"},"language":"en","primary_location":{"id":"doi:10.3109/09638288.2013.791727","doi":"https://doi.org/10.3109/09638288.2013.791727","is_oa":false,"landing_page_url":"https://doi.org/10.3109/09638288.2013.791727","pdf_url":null,"source":{"id":"https://openalex.org/S12843020","display_name":"Disability and Rehabilitation","issn_l":"0963-8288","issn":["0963-8288","1464-5165"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320449","host_organization_name":"Informa","host_organization_lineage":["https://openalex.org/P4310320449"],"host_organization_lineage_names":["Informa"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Disability and Rehabilitation","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5062708164","display_name":"Avraam Ploumis","orcid":"https://orcid.org/0000-0002-6828-3196","observed_orcids":["https://orcid.org/0000-0002-6828-3196"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Avraam Ploumis","raw_affiliation_strings":["Department of Orthopaedics and Rehabilitation, Rehabilitation Unit \"S. Niarchos\" and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedics and Rehabilitation, Rehabilitation Unit \"S. Niarchos\" and","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5044141615","display_name":"Dimitrios Varvarousis","orcid":"https://orcid.org/0000-0002-3639-9274","observed_orcids":["https://orcid.org/0000-0002-3639-9274"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Dimitrios Varvarousis","raw_affiliation_strings":["Department of Orthopaedics and Rehabilitation, Rehabilitation Unit \u201cS. Niarchos\u201d"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedics and Rehabilitation, Rehabilitation Unit \u201cS. Niarchos\u201d","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034121897","display_name":"Spyridon Konitsiotis","orcid":"https://orcid.org/0000-0002-5217-1317","observed_orcids":["https://orcid.org/0000-0002-5217-1317"]},"institutions":[{"id":"https://openalex.org/I4210141877","display_name":"University Hospital of Ioannina","ror":"https://ror.org/03zww1h73","country_code":"GR","type":"healthcare","lineage":["https://openalex.org/I4210141877"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Spyridon Konitsiotis","raw_affiliation_strings":["Department of Neurology, University Hospital of Ioannina IoanninaGreece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neurology, University Hospital of Ioannina IoanninaGreece","institution_ids":["https://openalex.org/I4210141877"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5108544191","display_name":"Alexander E. Beris","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Alexander Beris","raw_affiliation_strings":["Department of Orthopaedics and Rehabilitation, Rehabilitation Unit \u201cS. Niarchos\u201d"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedics and Rehabilitation, Rehabilitation Unit \u201cS. Niarchos\u201d","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5062708164"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":2.7502,"has_fulltext":false,"cited_by_count":36,"citation_normalized_percentile":{"value":0.89758272,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":98},"biblio":{"volume":"36","issue":"4","first_page":"313","last_page":"318"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11274","display_name":"Botulinum Toxin and Related Neurological Disorders","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11274","display_name":"Botulinum Toxin and Related Neurological Disorders","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10510","display_name":"Stroke Rehabilitation and Recovery","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2742","display_name":"Rehabilitation"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11097","display_name":"Cerebral Palsy and Movement Disorders","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2738","display_name":"Psychiatry and Mental health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/botulinum-toxin","display_name":"botulinum toxin","score":0.8889999985694885},{"id":"https://openalex.org/keywords/spasticity","display_name":"spasticity","score":0.8579999804496765},{"id":"https://openalex.org/keywords/hemiplegia","display_name":"hemiplegia","score":0.9629999995231628},{"id":"https://openalex.org/keywords/intramuscular-injection","display_name":"intramuscular injection","score":0.9300000071525574},{"id":"https://openalex.org/keywords/anatomical-landmarks","display_name":"anatomical landmarks","score":0.6940000057220459},{"id":"https://openalex.org/keywords/functional-outcome","display_name":"functional outcome","score":0.5759999752044678},{"id":"https://openalex.org/keywords/barthel-index","display_name":"Barthel Index","score":0.7229999899864197},{"id":"https://openalex.org/keywords/ashworth-scale","display_name":"Ashworth scale","score":0.746999979019165}],"concepts":[{"id":"https://openalex.org/C2779012798","wikidata":"https://www.wikidata.org/wiki/Q117060","display_name":"Spasticity","level":2,"score":0.7945001721382141},{"id":"https://openalex.org/C2777478456","wikidata":"https://www.wikidata.org/wiki/Q208413","display_name":"Botulinum toxin","level":2,"score":0.7200215458869934},{"id":"https://openalex.org/C99508421","wikidata":"https://www.wikidata.org/wiki/Q2678675","display_name":"Physical medicine and rehabilitation","level":1,"score":0.6895099878311157},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.6772832870483398},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6481444835662842},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.5823372602462769},{"id":"https://openalex.org/C2778818304","wikidata":"https://www.wikidata.org/wiki/Q1819478","display_name":"Rehabilitation","level":2,"score":0.4501042068004608},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.18548855185508728},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.1838158369064331}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004576","descriptor_name":"Electromyography","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006429","descriptor_name":"Hemiplegia","qualifier_ui":"Q000534","qualifier_name":"rehabilitation","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009128","descriptor_name":"Muscle Spasticity","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D009128","descriptor_name":"Muscle Spasticity","qualifier_ui":"Q000534","qualifier_name":"rehabilitation","is_major_topic":false},{"descriptor_ui":"D009465","descriptor_name":"Neuromuscular Agents","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D011446","descriptor_name":"Prospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016896","descriptor_name":"Treatment Outcome","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019274","descriptor_name":"Botulinum Toxins, Type A","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.3109/09638288.2013.791727","doi":"https://doi.org/10.3109/09638288.2013.791727","is_oa":false,"landing_page_url":"https://doi.org/10.3109/09638288.2013.791727","pdf_url":null,"source":{"id":"https://openalex.org/S12843020","display_name":"Disability and Rehabilitation","issn_l":"0963-8288","issn":["0963-8288","1464-5165"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320449","host_organization_name":"Informa","host_organization_lineage":["https://openalex.org/P4310320449"],"host_organization_lineage_names":["Informa"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Disability and Rehabilitation","raw_type":"journal-article"},{"id":"pmid:23672209","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/23672209","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Disability and rehabilitation","raw_type":"Comparative Study"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[{"display_name":"Randomized Controlled Trial","id":"https://openalex.org/study-designs/randomized-controlled-trial"},{"display_name":"Clinical Trial","id":"https://openalex.org/study-designs/clinical-trial"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":29,"referenced_works":["https://openalex.org/W1513130138","https://openalex.org/W1960948373","https://openalex.org/W1971453152","https://openalex.org/W1999983604","https://openalex.org/W2006522949","https://openalex.org/W2010076187","https://openalex.org/W2034709336","https://openalex.org/W2038227229","https://openalex.org/W2038840831","https://openalex.org/W2047179585","https://openalex.org/W2055127221","https://openalex.org/W2057125727","https://openalex.org/W2061961081","https://openalex.org/W2072475508","https://openalex.org/W2072573634","https://openalex.org/W2075120955","https://openalex.org/W2087921161","https://openalex.org/W2093171382","https://openalex.org/W2103595426","https://openalex.org/W2104616620","https://openalex.org/W2107536519","https://openalex.org/W2122977798","https://openalex.org/W2128208622","https://openalex.org/W2130873978","https://openalex.org/W2133262072","https://openalex.org/W2152890658","https://openalex.org/W2159108226","https://openalex.org/W2420598325","https://openalex.org/W4244015461"],"related_works":["https://openalex.org/W2295109662","https://openalex.org/W2336163730","https://openalex.org/W2512690529","https://openalex.org/W2890321497","https://openalex.org/W1966921323","https://openalex.org/W2318043205","https://openalex.org/W2522740187","https://openalex.org/W3031588899","https://openalex.org/W7072379741","https://openalex.org/W4365793262"],"abstract_inverted_index":{"PURPOSE:":[0],"To":[1],"compare":[2],"the":[3,16,85,105,131,153,189,245],"effects":[4],"of":[5,18,81,98,107,135,183,191,218,247,260],"botulinum":[6,52,185,214,242,261],"toxin":[7,53,186,215,243,262],"injection":[8,86,187,269,272],"with":[9,36,51,54,89,104,200,223,241,275],"and":[10,63,71,130,229,251],"without":[11,56,101,205],"needle":[12,90,201],"electromyographic":[13,91,102,202],"guidance":[14,103,203,225,250,255],"for":[15,188],"treatment":[17,190],"spasticity.":[19],"METHOD:":[20],"A":[21,144,176],"randomized":[22],"controlled":[23],"study":[24],"was":[25,87,114,122,137,236],"conducted":[26],"in":[27,67,94,127,142,174,193,238],"a":[28],"tertiary":[29],"university":[30],"hospital.":[31],"Twenty-seven":[32],"adult":[33],"hemiplegic":[34,194,219],"patients":[35,83,96,129,195,239],"spasticity":[37,121,136,192,227,266],"due":[38,263],"to":[39,264],"brain":[40],"or":[41,55],"spinal":[42],"cord":[43],"damage":[44],"were":[45,49,73],"included.":[46],"Spastic":[47],"muscles":[48],"injected":[50,240],"EMG":[57,224,249,254],"guidance.":[58],"The":[59,111,181],"modified":[60,64,157],"Ashworth":[61],"scale":[62],"Barthel":[65,158],"index":[66,159],"each":[68],"patient":[69],"pre-":[70],"post-injection":[72,166,235],"documented.":[74],"RESULTS:":[75],"In":[76],"group":[77,99,143,148,175],"A,":[78],"which":[79],"consisted":[80],"15":[82],"(55.55%),":[84],"administered":[88],"guidance,":[92],"while":[93],"12":[95],"(44.44%)":[97],"B":[100,149],"use":[106,246],"anatomic":[108,252,276],"landmarks":[109,253,277],"only.":[110,278],"follow-up":[112],"period":[113],"3":[115,118,233],"months.":[116],"At":[117],"weeks":[119],"post-injection,":[120],"decreased":[123],"(p":[124,139,163,177],"<":[125,140,164,178],"0.05)":[126,141],"all":[128],"mean":[132,154],"(SD)":[133,155],"reduction":[134,228],"higher":[138],"(1.67":[145],"(0.5))":[146],"than":[147,169,204,270],"(1.25":[150],"(0.46)).":[151],"Similarly,":[152],"functional":[156,230],"improved":[160],"statistically":[161],"significantly":[162],"0.001)":[165],"(45.37":[167],"(8.43))":[168],"pre-injection":[170],"(54.07":[171],"(9.610),":[172],"especially":[173],"0.05).":[179],"CONCLUSION:":[180],"effectiveness":[182],"intramuscular":[184],"is":[196,211,273],"superior":[197],"when":[198,271],"performed":[199,222,274],"electromyography.":[206],"IMPLICATIONS":[207],"FOR":[208],"REHABILITATION:":[209],"It":[210],"recommended":[212],"that":[213],"muscle":[216],"injections":[217],"limbs":[220],"be":[221],"More":[226],"improvement":[231],"at":[232],"months":[234],"observed":[237,267],"by":[244],"combined":[248],"might":[256],"also":[257],"save":[258],"amount":[259],"less":[265],"during":[268]},"counts_by_year":[{"year":2026,"cited_by_count":2},{"year":2025,"cited_by_count":3},{"year":2024,"cited_by_count":2},{"year":2023,"cited_by_count":2},{"year":2022,"cited_by_count":4},{"year":2021,"cited_by_count":2},{"year":2020,"cited_by_count":1},{"year":2019,"cited_by_count":3},{"year":2018,"cited_by_count":1},{"year":2017,"cited_by_count":3},{"year":2016,"cited_by_count":4},{"year":2015,"cited_by_count":4},{"year":2014,"cited_by_count":5}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}