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Table 3 Dose range, muscle distribution, and mean dose of onabotulinumtoxinA injections in lower limbs

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

Muscles

All studies (37 studies, 47 treatment arms)

Studies reporting number of patients injected (31 studies, 40 treatment arms)

Studies reporting mean dose (24 studies, 29 treatment arms)

 

k

t

Dose range (U)

k

t

n/N

Frequency (%)

k

t

N

Mean dose (U)

Hip adductors

           

Adductor longus

4

4

50–400

4

4

26/602

4.3

3

3

17

115.9

Adductor magnus

5

5

20–200

5

5

26/602

4.3

4

4

17

142.4

Adductor brevis

3

3

50–100

3

3

12/602

2.0

3

3

12

91.7

Hip adductors

5

6

50–160

3

3

32/602

5.3

0

0

0

NR

Hip flexors

           

Iliopsoas

2

2

40–100

2

2

5/602

0.8

0

0

0

NR

Psoas major

1

1

NR

1

1

1/602

0.2

0

0

0

NR

Rectus femoris

6

6

30–200

6

6

42/602

7.0

4

4

32

186.9

Knee flexors

           

Biceps femoris

6

6

30–200

5

5

34/602

5.6

2

2

6

56.7

Hamstrings

1

1

50–200

0

0

NR

NR

0

0

0

NR

Knee flexors

1

2

NR

0

0

NR

NR

0

0

0

NR

Semimembranosus

8

8

40–200

6

6

41/602

6.8

3

3

4

75.0

Semitendinosus

6

6

30–200

4

4

42/602

7.0

1

1

5

34.0

Knee extensors

           

Quadriceps

1

1

NR

0

0

NR

NR

0

0

0

NR

Vastus intermedius

1

1

NR

1

1

4/602

0.7

0

0

0

NR

Vastus lateralis

4

4

25–60

3

3

4/602

0.7

2

2

3

38.3

Vastus medialis

3

3

30

2

2

4/602

0.7

1

1

1

30.0

Ankle plantar flexors

           

Gastrocnemius

31

36

20–320

26

31

398/602

66.1

16

19

246

88.2

Gastrocnemius lateralis

13

14

50–200

12

13

164/602

27.2

9

9

130

86.7

Gastrocnemius medialis

13

14

50–200

12

13

165/602

27.4

9

9

131

86.8

Soleus

25

28

40–240

21

24

329/602

54.7

14

16

233

95.2

Tibialis anterior

7

7

30–150

5

5

50/602

8.3

2

2

37

56.8

Tibialis posterior

24

29

20–200

18

23

304/602

50.5

11

15

218

80.7

Foot flexors/extensors

           

Extensor hallucis longus

6

6

25–100

5

5

22/602

3.7

4

4

20

71.9

Flexor hallucis longus

7

7

15–95

7

7

33/602

5.5

4

4

22

50.9

Foot flexors

1

2

NR

0

0

NR

NR

0

0

0

NR

Small foot flexors

1

1

50

1

1

5/602

0.8

1

1

5

50.0

Toe flexors

           

Flexor digitorum longus

10

12

20–125

10

12

75/602

12.5

6

8

50

57.2

Flexor digitorum brevis

6

8

20–100

5

7

25/602

4.2

3

5

18

54.4

Flexor hallucis brevis

2

2

10–15

2

2

3/602

0.5

2

2

3

11.7

  1. 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.
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BMC Neurology

ISSN: 1471-2377

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