Does botulinum toxin type A decrease pain and lessen disability in hemiplegic survivors of stroke with shoulder pain...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Pain Management

Background:

• Stroke survivors frequently experience shoulder pain and spasticity, significantly impacting quality of life.
• Botulinum toxin type A is a potential therapeutic agent for managing spasticity and associated symptoms.

Purpose of the Study:

• To evaluate the effectiveness of botulinum toxin type A injections in alleviating pain, impairment, and disability in stroke patients with shoulder spasticity.

Main Methods:

• A prospective, randomized, double-blind, placebo-controlled trial involving 21 adults with post-stroke shoulder spasticity (Modified Ashworth Scale 3-4).
• Participants received either onabotulinumtoxinA (Botox) or placebo (saline) injections into shoulder muscles.
• Assessments included pain ratings (visual analog scale), Disability Assessment Scale, McGill Pain Questionnaire, Fugl-Meyer Scale, range of motion, and Modified Ashworth Scale at baseline and up to 12 weeks post-injection.

Main Results:

• Both botulinum toxin type A and placebo groups demonstrated reduced pain scores at 4 weeks, with no statistically significant difference between them.
• The botulinum toxin type A group showed significant improvement in hygiene scores on the Disability Assessment Scale compared to placebo at 4 weeks.
• A trend towards significance was observed for improvement in dressing scores on the Disability Assessment Scale in the botulinum toxin type A group.

Conclusions:

• While botulinum toxin type A injections improved certain disability measures for shoulder spasticity and pain post-stroke, pain reduction was comparable to placebo.
• Further research may be needed to optimize the use of botulinum toxin type A for comprehensive management of post-stroke shoulder dysfunction.