Animal and @entity1 studies have shown that nerve stimulation enhances some effects of botulinum toxin (btx A) injection. @entity121 might work similarly and would focus the effect of an injection into the active muscles. We studied the effects of exercise immediately after btx A injection in eight @entity1 with @entity3520 with established response to btx A over two injection cycles with a single-blinded, randomized, crossover design. Immediately after the first study injection, they were randomly assigned to write continuously for 30 min or have their hand and forearm immobilized for 30 min. Following the second injection, they were assigned the alternate condition. @entity1 were assessed just before each injection, and at 2 weeks, 6 weeks, and 3 months post-injection. Assessment included objective strength testing, self-reported rating of benefit and weakness, and blinded evaluation of videotapes and writing samples of the @entity1 writing a standard passage. Strength testing showed that the maximum weakness occurred at 2 weeks post-injection, but the benefit was maximum at 6 weeks post-injection. The "write" condition resulted in greater reduction in strength than the "rest" condition. Btx A treatment led to improvement in self-reported ratings, @entity3520 rating scale scores by blinded raters, and reduction in writing time, but the differences between the "write" and "rest" conditions were not significant. We conclude that @entity121 immediately after btx A injection leads to greater reduction in muscle strength. Our findings raise the possibility that voluntary muscle activation may allow reduction of btx A doses and favorably alter the balance of benefit and side effects of btx A injections.

Effect of muscle activity immediately after botulinum toxin injection for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'human', 'patients'] @entity3520 :: ('MESH:D020821', 'Disease') :: ["writer's cramp"] @entity121 :: ('MESH:D009135', 'Disease') :: ['Voluntary muscle activity', 'voluntary muscle activity']
@entity3520 :: (MESH:D020821,Disease) :: ['writer's cramp']
