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Spasticity and Range of Motion Over Time in Stroke Patients Who Received Multiple-Dose Botulinum Toxin Therapy.
J Stroke Cerebrovasc Dis. 2020 Jan; 29(1):104481.JS

Abstract

OBJECTIVE

This study examined how the effects of botulinum toxin therapy changed over time by sequential evaluation of clinical improvements in spasticity and contracture in 24 chronic-stage stroke patients on repeated botulinum toxin therapy who were receiving fewer rehabilitation interventions.

METHODS

Botulinum toxin injection was administered into the spastic muscle of the paralyzed upper or lower limb 5 times with at least 3-month intervals. Modified Ashworth Scale and range of motion were measured before and 2 weeks after each dose in the extremities to compare the first measurement value with subsequent values. Each predose value was also compared with the first predose value.

RESULTS

Compared with predose scores, Modified Ashworth Scale significantly improved in all flexors after 2 weeks from the first to fifth doses. Range of motion significantly improved in wrist dorsiflexion and ankle dorsiflexion. Comparison of values before each dose versus the first predose value showed significant improvement both in the Modified Ashworth Scale score of wrist flexors, finger flexors, and ankle planter flexors, and the range of motion of elbow extension, wrist dorsiflexion, and ankle dorsiflexion.

CONCLUSION

The comparison of predose values versus 2-week postdose values indicated that the effect of botulinum toxin formulation would not lessen after repeated injections with continuous improvements of Modified Ashworth Scale and range of motion. The comparison of predose values versus the first predose value also suggested that multiple injections of botulinum toxin formulation could be more effective in reducing spasticity and increasing the range of motion than a single injection.

Authors+Show Affiliations

Rehabilitation Unit, Asahikawa Medical University Hospital, Asahikawa, Japan. Electronic address: keio_tukigase_ro@yahoo.co.jp.Department of Physical Medicine and Rehabilitation, Asahikawa Medical University Hospital, Asahikawa, Japan.Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.Department of Physical Medicine and Rehabilitation, Asahikawa Medical University Hospital, Asahikawa, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31699575

Citation

Ro, Takanori, et al. "Spasticity and Range of Motion Over Time in Stroke Patients Who Received Multiple-Dose Botulinum Toxin Therapy." Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, vol. 29, no. 1, 2020, p. 104481.
Ro T, Ota T, Saito T, et al. Spasticity and Range of Motion Over Time in Stroke Patients Who Received Multiple-Dose Botulinum Toxin Therapy. J Stroke Cerebrovasc Dis. 2020;29(1):104481.
Ro, T., Ota, T., Saito, T., & Oikawa, O. (2020). Spasticity and Range of Motion Over Time in Stroke Patients Who Received Multiple-Dose Botulinum Toxin Therapy. Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, 29(1), 104481. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104481
Ro T, et al. Spasticity and Range of Motion Over Time in Stroke Patients Who Received Multiple-Dose Botulinum Toxin Therapy. J Stroke Cerebrovasc Dis. 2020;29(1):104481. PubMed PMID: 31699575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spasticity and Range of Motion Over Time in Stroke Patients Who Received Multiple-Dose Botulinum Toxin Therapy. AU - Ro,Takanori, AU - Ota,Tetsuo, AU - Saito,Tsukasa, AU - Oikawa,Ou, Y1 - 2019/11/04/ PY - 2019/06/08/received PY - 2019/09/05/revised PY - 2019/10/11/accepted PY - 2019/11/9/pubmed PY - 2019/11/9/medline PY - 2019/11/9/entrez KW - Modified Ashworth Scale KW - Spasticity KW - botulinum toxin A therapy KW - range of motion KW - stroke SP - 104481 EP - 104481 JF - Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association JO - J Stroke Cerebrovasc Dis VL - 29 IS - 1 N2 - OBJECTIVE: This study examined how the effects of botulinum toxin therapy changed over time by sequential evaluation of clinical improvements in spasticity and contracture in 24 chronic-stage stroke patients on repeated botulinum toxin therapy who were receiving fewer rehabilitation interventions. METHODS: Botulinum toxin injection was administered into the spastic muscle of the paralyzed upper or lower limb 5 times with at least 3-month intervals. Modified Ashworth Scale and range of motion were measured before and 2 weeks after each dose in the extremities to compare the first measurement value with subsequent values. Each predose value was also compared with the first predose value. RESULTS: Compared with predose scores, Modified Ashworth Scale significantly improved in all flexors after 2 weeks from the first to fifth doses. Range of motion significantly improved in wrist dorsiflexion and ankle dorsiflexion. Comparison of values before each dose versus the first predose value showed significant improvement both in the Modified Ashworth Scale score of wrist flexors, finger flexors, and ankle planter flexors, and the range of motion of elbow extension, wrist dorsiflexion, and ankle dorsiflexion. CONCLUSION: The comparison of predose values versus 2-week postdose values indicated that the effect of botulinum toxin formulation would not lessen after repeated injections with continuous improvements of Modified Ashworth Scale and range of motion. The comparison of predose values versus the first predose value also suggested that multiple injections of botulinum toxin formulation could be more effective in reducing spasticity and increasing the range of motion than a single injection. SN - 1532-8511 UR - https://www.unboundmedicine.com/medline/citation/31699575/Spasticity_and_Range_of_Motion_Over_Time_in_Stroke_Patients_Who_Received_Multiple-Dose_Botulinum_Toxin_Therapy L2 - https://linkinghub.elsevier.com/retrieve/pii/S1052-3057(19)30565-8 DB - PRIME DP - Unbound Medicine ER -
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