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Background

Between 50 per cent and 70 per cent of stroke patients have ongoing upper limb functional limitations. Upper limb spasticity may contribute to reduced function, pain and deformity. Botulinum toxin type A is used increasingly to treat focal spasticity in neurological rehabilitation, but its impact on upper limb function after stroke is unclear.

Aim

The Botulinum Toxin for the Upper Limb after Stroke (BoTULS) trial evaluated the clinical effectiveness and cost-effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post-stroke upper limb spasticity.

Design