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Onset of action, duration and maximum efficacy of different botulinum toxin type A (BoNT/A) preparations have been compared mainly in in vitro studies. This single-center open study compared onset of action of the two BoNT/A preparations onabotulinumtoxinA (complex size 900 kDa) and incobotulinumtoxinA (free of complexing proteins, 150 kDa) in patients with spasticity after cerebral stroke over a 15-day treatment period. Outcome measures were changes in muscle tone, increase in passive extension of the elbow, changes in limb functionality, and variation of the amplitude of the compound muscle action potential (cMAP) determined by electroneurography. A total of 108 patients (mean age 64.8 ± 11.3 years) were included in the study, 54 in each treatment arm. Muscle tone, elbow motion range, and limb function significantly improved in both groups from baseline to day 15 after BoNT/A injection (p

Background: The multiple sclerosis is often associated with motor impairment and disorders of gait and balance, which are thought to be the main causes of the worsening of quality of life and functional autonomy. Many people with multiple sclerosis have a higher incidence of falls than healthy people, so that they risk more traumas; the lack of movement related to the motor impairment is therefore enhanced by the fear of falls. Aims: To assess the efficacy of the "Prokin"system, composed of balance board and visual/acoustic feedback, associated with conventional proprioceptive training in increasing static and dynamic balance, proprioception, coordination and functional autonomy in patients with multiple sclerosis and to compare it with conventional physical therapy. Methods: We enrolled 23 patients with defined SM (4 men, 19 women) divided into 2 groups (A and B). Patients of group A (14) underwent 2 series of 10 sessions of 2-a-week proprioceptive training with Prokin system; patients of group B (5) underwent 2 series of 10 sessions of a 3-a-week conventional balance training. Each patient was assessed at t0 (before training), t1 (after 10 sessions) and t2 (after 20 sessions) with clinical scales for balance control (Tinetti, Berg) and autonomy (Barthel), and with instrumental tests (stabilometry, analyzing sway area, length of track and sway speed; and proprioceptive multiaxial assessment, exploring the Average Track Error). Results: In group A we found statistically significant (p