Systematic review finds limited adjunct therapies for botulinum toxin in spasticity management of MS, suggesting a need for more research.
Background/Objectives: The objective of this review is to document the modalities to enhance the neuromuscular effects of botulinum toxin (BoNT) injection in spastic patients with multiple sclerosis (MS). Methods: We conducted a literature review focusing on studies involving BoNT administration for MS-related spasticity and the use of adjunctive therapies aimed at reducing dosage and increasing injection intervals. Results: The findings revealed a limited number of studies specific to MS patients, addressing only a few adjunct techniques, including electrical stimulation, vibration therapy, physical exercise, and extracorporeal shock wave therapy. Conclusions: These preliminary findings highlight the need for further research into integrative therapeutic strategies tailored specifically to the MS population.
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Poenaru et al. (2025) studied this question.
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