Table 1.
Details of included articles.
| Research (First Author, Year of Publication) | Country | Study Design (Number of Participants) | Mean Age at the Time of First Injection (Years Old) | Gender (Percentage of Male) | Mean Dosage of BoNT | Site(s) of Injection | Commercial Forms of BoNT (Company) | Outcome Measurements | Pre-Injection Operation (n, Percentage) | Percentage of Adverse Event | Last Time of Outcome Measurement (Months Post-Injection) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Rollnik, 2000 [30] | Germany | Case series (6) | 3.17 | 0 | 39.2 units/muscle | Triceps | Dysport (Ipsen) | Triceps MRC, active ROM of elbow extension | nerve repair (3, 50%) | 0 | 12 |
| Desiato, 2001 [31] | Italy | Case series (50) | 4.7 | 52 | 14.4 units/kg | Pectoralis major, pectoralis minor, teres major, Biceps brachii, Brachialis, Pronator teres, Subscapularis, latissimus dorsi, brachioradialis | Dysport (Ipsen) | Active ROM of elbow extension, shoulder external rotation, Global Clinical Rating Scale | tendon lengthening (5, 10%) | 2 (transient weakness) | 9 |
| Basciani, 2006 [32] | Italy | Case series (22) | 5.6 | 54.5 | 22 units/kg | Pectoralis major, Biceps brachii, Brachialis, Pronator teres | Dysport (Ipsen) | MRC of biceps, triceps and deltoid active ROM of elbow extension, Mallet score, Nine-Hole Peg Test (NHPT) | N/R | 9.1 (articular pain) | 12 |
| DeMatteo, 2006 [33] | Canada | Case series (8) | 1.04 | 62.5 | 4 units/kg/muscle | Triceps, pectoralis major, latissimus dorsi | Botox (Allergan) | AMS of elbow shoulder flexion, abduction and total external rotation | tendon lengthening (4), nerve repair (3) | N/R | 4 |
| Price, 2007 [40] | USA | Retrospective cohort (13 in treatment group) | 5.8 (treatment group) | 46.2 (treatment group) | 100 units/muscle | pectoralis major | N/A | Modified Gilbert score for shoulder abduction | tendon transfer (13, 100%) | N/R | N/R (Mean follow-up time 36) |
| Ezaki, 2010 [10] | USA | Case series (35) | 0.48 | 48.6 | N/R (2–3 units/kg/muscle) | latissimus dorsi, pectoralis major, subscapularis, teres major | Botox (Allergan) | Recurrence rate after reduction for subluxation and dislocation | None (0, 0%) | 0 | 12 |
| Arad, 2013 [34] | Canada | Case series (27)(19 shoulder, 8 elbow) | 2.69 | 29.6 | N/R (40–50 units/muscle for shoulder; 60–75 units/muscle for elbow) | latissimus dorsi, pectoralis major, subscapularis, triceps | Botox (Allergan) | AMS of elbow flexion, shoulder external rotation | nerve repair (17, 63%) | 0 | 12 |
| Shin, 2014 [35] | Korea | Case series (4) | 6.65 | N/R | N/R (2–3 units/kg/muscle) | triceps brachii, pectoralis major | Botox (Allergan) | MRC of biceps and deltoid, Modified Gilbert score | N/R | N/R | 1 |
| Michaud, 2014 [36] | USA | Case series (59) | 3.02 | 52.5 | N/R (up to 10 units/kg) | latissimus dorsi, pectoralis major, subscapularis, triceps, biceps, pronator teres, flexor carpi ulnaris | Botox (Allergan) | Passive ROM of shoulder external rotation, Toronto score for elbow flexion and extension, Mallet score | nerve repair (28), tendon release (8), tendon transfer (4) | N/R | N/R (Mean follow-up time 13.2) |
| Duijnisveld, 2017 [41] | Netherland | Prospective cohort (15 in treatment group) | 2.53 (treatment group) | 66.7 (treatment group) | 2 units/kg | subscapularis | Botox (Allergan) | Passive ROM of shoulder external rotation | nerve repair (10, 75%) | 0 | 3 |
| Greenhill, 2018 [37] | USA | Case series (49) | 0.96 | N/R | N/R (up to 10 units/kg) | latissimus dorsi, pectoralis major, subscapularis | Botox (Allergan) | Passive ROM of shoulder external rotation | None (0, 0%) | 0 | N/R (Mean follow-up time 21.1) |
| Singh, 2020 [38] | USA | Case series (47) | 1 | 44.7 | 7.4 units/kg | latissimus dorsi, pectoralis major, subscapularis | OnabotulinumtoxinA (Allergan) | AMS of shoulder external rotation, Passive ROM of shoulder external rotation | nerve repair (20, 42.6%) | N/R | 11 |
| Morscher, 2020 [39] | USA | Case series (12) | 0.33 | N/R | N/R (range: 10–30 units/muscle) | triceps | OnabotulinumtoxinA (Allergan) | Toronto score elbow flexoin | None (0, 0%) | 0 | N/R (Mean follow-up time 72) |
AMS: Active Movement Scale, BoNT: botulinum neurotoxin, MRC: Medical Research Council scale, ROM: range of motion, N/A: not applicable, N/R: not reported.