Andringa A, et al. - A total of 1,212 unique records were screened by two researchers in order to give a comprehensive overview of reported impacts and scientific robustness of botulinum toxin (BoNT) treatment regarding the main clinical goals associated with poststroke upper limb spasticity, using the International Classification of Functioning, Disability, and Health. In decreasing resistance to passive movement, robust evidence was exhibited for the efficiency of BoNT and improving self-care ability for the affected hand and arm following the intervention and at follow-up, as measured with the (Modified) Ashworth Score. Moreover, for the absence of an impact on arm-hand capacity, robust evidence was demonstrated at follow-up. BoNT was discovered to significantly decrease involuntary movements, spasticity-related pain, and caregiver burden, and enhance the passive range of motion, while for arm and hand use following the intervention, it was not evident. Therefore, no further trials are required to examine BoNT for its favorable impacts on resistance to passive movement of the spastic wrist and fingers, and on self-care, in view of the robustness of current evidence. No trials are required to additional validate the lack of influences of BoNT on arm-hand capacity, whereas further trials are required to authenticate the recommended favorable impacts of BoNT on other body functions, which may lead to clinically significant outcomes at activity and participation levels.