Upper-limb Active Function and Botulinum Toxin a

Exclusion Criteria

• •Passive limitation of elbow extension \> 30 degrees;
• •Pain during active movements of elbow flexion/extension;
• •Cognitive disorder with limited comprehension of three basic instructions (like the test of the 3 papers of the MMS);
• •Evolutionary or decompensated neurological disease;
• •Unstabilized epilepsy;
• •Anticoagulant treatment with a curative dose or hemostasis disorder that contraindicates intramuscular injections;
• •Claustrophobia or metallic foreign bodies contraindicated for MRI;
• •General contraindication for botulinum toxin injection: hypersensitivity to the active substance or to one of the excipients, swallowing disorder, chronic respiratory disorders, antecedent of myasthenia or Lambert Eaton syndrome; antecedent of neuromuscular disease; surgery with curarization for less than a month; current treatment with aminoglycoside, aminoquinoline, cyclosporine or anticholinesterase.
• •Presence of skin infection or inflammation at the injection site.
• •Legal incapacity.
• •Pregnant or breastfeeding woman;
• •Woman with a desire to become pregnant within 18 months.
• •Non-menopausal woman (a postmenopausal state is defined as no menses for 12 months without an alternative medical cause) who does not use one of the following contraceptive methods considered highly effective : intrauterine device, oestroprogestonic contraception or progestogen hormonal contraception associated with inhibition of ovulation, intrauterine hormone-releasing system, or bilateral tubal occlusion.
• •Control group
• •* History of orthopedic or neurologic disorders;
• •* Subject expert in a sport intensively requiring the upper limbs (at least departmental competition level);
• •* Legal incapacity.