Related Experiment Video
Updated: May 26, 2026
Application of a Dual Upper Limb Task-Oriented Robotic System for the Functional Recovery of the Upper Limb in Stroke Patients
Published on: October 11, 2024
Further assessment to determine the additive effect of botulinum toxin type A on an upper extremity exercise program
Steven L Wolf1, S Byron Milton, Aimee Reiss
1Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. swolf@emory.edu
Objective:
To determine whether dose-specified botulinum toxin type A (BTX-A) and a standardized exercise protocol produce better upper extremity function than placebo and the same exercise program.
Design:
Double-blind randomized trial.
Setting:
A rehabilitation research center.
Participants:
A convenience sample of patients (N=25, age range, 23-76 y) who sustained a stroke 3 to 24 months previously but could initiate wrist extension.
Interventions:
Participants were randomly selected to receive either BTX-A (maximum 300 U) or saline, followed by 12 to 16 exercise sessions.
Main Outcome Measures:
The primary outcome was the Wolf Motor Function Test (WMFT). Secondary outcome measures included the Modified Ashworth Scale (MAS), active range of motion, and the Stroke Impact Scale (SIS; quality of life).
Results:
There were no group-by-time interactions for changes in the WMFT and no treatment difference (P=.86), although the BTX-A group could complete more tasks governing proximal joint motions. MAS scores improved for the BTX-A group and worsened for the control group after injection (P=.02), as did the SIS emotion domain (P=.035).
Conclusions:
Among chronic stroke survivors, BTX-A did not impact function, movement, or tone more than a standardized exercise program.
