Does botulinum toxin improve the function of the patient with spasticity after stroke?

Area of Science:

• Neurology
• Rehabilitation Medicine
• Physical Therapy

Background:

• Post-stroke spasticity significantly contributes to adult disability, characterized by muscle hyperactivity, stiffness, and spasms.
• Effective management and physical therapy are crucial for preventing complications like muscle shortening and pain.

Purpose of the Study:

• To evaluate if individualized botulinum toxin type A (BT-A) injections enhance upper limb function in adult post-stroke spastic patients.
• To assess the long-term effects of BT-A therapy on spasticity and functional recovery.

Main Methods:

• A prospective study followed 20 adult patients with spastic hemiparesis post-stroke.
• Botulinum toxin type A (BT-A) was administered at baseline and week 16, alongside rehabilitation therapy.
• Assessments included the modified Fulg-Meyer scale, Functional Independence Measure (FIM), modified Ashworth scale, and goniometry at baseline, week 16, and week 32.

Main Results:

• All patients demonstrated reduced spasticity (modified Ashworth scale) and increased range of motion, sustained through week 32 (p<0.05).
• Statistically significant improvements were observed in the modified Fulg-Meyer scale and the motor component of the FIM until study completion.
• BT-A injections, tailored to specific muscles and doses, proved effective in improving function.

Conclusions:

• Individualized botulinum toxin type A (BT-A) injections, combined with rehabilitation, can significantly improve upper limb function in selected post-stroke spastic patients.
• This therapeutic approach leads to sustained reductions in spasticity and enhancements in motor function and independence.