LONG-TERM EFFICACY OF SPASTICITY-CORRECTIVE SURGERY AND BOTULINUM TOXIN INJECTIONS FOR UPPER LIMB SPASTICITY...

Area of Science:

• Orthopedic Surgery
• Neurology
• Rehabilitation Medicine

Background:

• Upper limb spasticity significantly impacts patient function and quality of life.
• Current treatments include surgical interventions and pharmacological approaches like botulinum toxin injections.
• Long-term comparative efficacy data between these treatment modalities are crucial for clinical decision-making.

Purpose of the Study:

• To compare the long-term efficacy of spasticity-corrective surgery versus botulinum toxin treatment.
• To evaluate effects on spasticity severity, range of motion, grip strength, and functional outcomes.

Main Methods:

• A pretest-posttest quasi-experimental study involving 34 patients with disabling upper limb spasticity.
• Patients were allocated to either a surgery group (tendon lengthening/release, n=17) or a botulinum toxin injection group (n=17).
• Outcomes measured included the Modified Ashworth Scale, range of motion, grip strength, and activity performance at various time points.

Main Results:

• The surgery group showed significantly greater reduction in spasticity (Modified Ashworth Scale) compared to the botulinum toxin group.
• Surgery resulted in superior improvements in range of motion, grip strength, task performance, and patient satisfaction.
• Botulinum toxin demonstrated transient effects, whereas surgical intervention provided sustained functional benefits.

Conclusions:

• Spasticity-corrective surgery is more effective and provides longer-lasting benefits than botulinum toxin for upper limb spasticity.
• Surgical intervention should be considered for patients requiring durable spasticity management.
• These findings support tailored treatment strategies based on desired duration of effect.