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Table 2 Dose range, muscle distribution, and mean dose of onabotulinumtoxinA injections in upper limbs

From: OnabotulinumtoxinA muscle injection patterns in adult spasticity: a systematic literature review

Muscles

All studies (44 studies, 58 treatment arms)

Studies reporting number of patients injected (33 studies, 46 treatment arms)

Studies reporting mean dose (26 studies, 39 treatment arms)

 

k

t

Dose range (U)

k

t

n/N

Frequency (%)

k

t

n

Mean dose (U)

Shoulder

           

Infraspinatus

2

2

60

2

2

18/788

2.3

1

1

2

60.0

Shoulder adductors**

1

1

30–100

1

1

8/788

1.0

1

1

8

55.6

Deltoid

1

1

NR

1

1

1/788

0.1

0

0

0

NR

Latissimus dorsi

1

1

50–100

1

1

14/788

1.8

1

1

14

66.1

Levator scapulae

1

1

NR

1

1

1/788

0.1

0

0

0

NR

Paraspinous

1

1

100

1

1

1/788

0.1

1

1

1

100.0

Pectoralis

7

7

30–100

5

5

39/788

4.9

3

3

22

67.3

Rhomboid

1

1

50

1

1

8/788

1.0

1

1

8

50.0

Sternocleidomastoid

1

1

NR

1

1

2/788

0.3

0

0

0

NR

Subscapularis

2

2

100

2

2

26/788

3.3

1

1

10

100.0

Teres major

1

1

40

1

1

1/788

0.1

1

1

1

40.0

Trapezius

2

2

60

2

2

3/788

0.4

1

1

1

60.0

Triceps brachii

5

6

50–100

4

4

10/788

1.3

3

3

9

73.6

Forearm

           

Extensor carpi radialis

3

4

5–50

3

4

6/788

0.8

2

3

4

17.5

Extensor carpi ulnaris

1

2

5–10

1

2

3/788

0.4

1

2

3

6.7

Extensor digitorum

1

1

NR

1

1

1/788

0.1

0

0

0

NR

Pronator quadrates

2

2

25

1

1

1/788

0.1

0

0

0

NR

Pronator teres

14

16

10–90

10

11

96/788

12.2

6

7

65

33.3

Supinator

1

1

5

1

1

1/788

0.1

1

1

1

5.0

Elbow flexors

           

Biceps brachii*

30

40

25–200

19

27

306/788

38.8

16

24

263

95.4

Brachialis

10

12

20–100

4

4

27/788

3.4

1

1

1

60.0

Brachioradialis

17

20

15–200

9

11

104/788

13.2

7

9

75

41.1

Wrist flexors

           

Flexor carpi radialis*

34

45

5–100

24

34

504/788

64.0

18

28

433

49.0

Flexor carpi ulnaris*

34

45

5–100

23

33

466/788

59.1

18

28

420

46.7

Palmaris longus

3

3

20–25

2

2

8/788

1.0

1

1

4

23.8

Wrist flexors

1

1

50–120

1

1

20/788

2.5

1

1

20

72.8

Finger flexors

           

Finger flexors§

1

1

30–160

1

1

20/788

2.5

1

1

20

97.8

Flexor digitorum profundus*

31

39

5–120

20

27

414/788

52.5

16

23

361

42.0

Flexor digitorum superficialis*

31

40

5–150

20

28

451/788

57.2

16

24

386

50.3

Forearm finger flexor

1

1

80

1

1

5/788

0.6

1

1

5

80.0

Interossei volares

1

1

10–15

1

1

4/788

0.5

1

1

4

11.3

Thumb

           

Adductor pollicis

7

8

10–20

5

6

102/788

12.9

3

4

93

18.9

Flexor pollicis brevis

1

1

NR

1

1

2/788

0.3

0

0

0

NR

Flexor pollicis longus

20

24

10–35

11

13

161/788

20.4

7

9

132

19.0

Lumbricals

3

4

30

2

2

4/788

0.5

1

1

1

30.0

Opponens

1

1

10

0

0

NR

NR

0

0

0

NR

Opponens pollicis

2

2

NR

1

1

4/788

0.5

0

0

0

NR

Other muscles

           

Other upper-limb muscles

1

1

NR

0

0

NR

NR

0

0

0

NR

Upper-limb flexors

1

1

50–150

0

0

NR

NR

0

0

0

NR

  1. *Muscles currently approved in the United States for onabotulinumtoxinA injection.
  2. **Deltoid, pectoralis major.
  3. Reported as “dorsalis major”.
  4. Flexor carpi radialis, palmaris longus, flexor carpi ulnaris.
  5. §Flexor pollicis longus, flexor digitorum profundus, flexor digitorum superficialis.
  6. k = Number of studies, t = Number of treatment arms, n = Number of patients injected with onabotulinumtoxinA, N = Total number of patients in treatment arms reporting number of patients injected with onabotulinumtoxinA, NR = Not reported, U = Units.