scholarly journals Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Michiko Arima ◽  
Atsuko Ogata ◽  
Kazumi Kawahira ◽  
Megumi Shimodozono
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Near Infrared ◽  
Botulinum Toxin Type A ◽  
Combined Treatment ◽  
Neuromuscular Electrical Stimulation ◽  
Botulinum Toxin Type ◽  
Functional Improvement ◽  
Upper Limb Function ◽  
Flexor Muscles

The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin type A (BTX-A) was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb. In addition, repetitive facilitative exercise and object-related training were performed under low-amplitude continuous neuromuscular electrical stimulation. Since this 2-week treatment improved upper limb function, we compared brain activities, as measured by near-infrared spectroscopy during finger pinching, before and after the combined treatment. Brain activities in the ipsilesional sensorimotor cortex (SMC) and medial frontal cortex (MFC) during pinching under electrical stimulation after treatment were greater than those before. The results suggest that training under electrical stimulation after BTX-A treatment may modulate the activities of the ipsilesional SMC and MFC and lead to functional improvement of the affected upper limb with forced grasping.

scholarly journals Efficiency of Different Preparations of Botulinum Toxin Type A, Xeomin and Dysport, in the Management of Spastic Upper Limb After Stroke

2019 ◽  
Vol 70 (10) ◽  
pp. 3490-3494
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Local Effect ◽  
National Agency ◽  
Good Efficiency ◽  
Upper Limb Function ◽  
Higher Doses

The present study quantifies the effect of the two botulinum toxin type A products, Xeomin and Dysport, with approval from the National Agency for Medicines and Medical Devices of Romania (ANMDMR), for the treatment of the spastic upper limb following a stroke. The results obtained in the present study show a good efficiency of using both products in the spasticity of the upper limb, and a maintenance of the results obtained for both products for a minimum period of 3 months. Also, at higher doses, the results of the study show better improvement of spasticity and upper limb function on the evaluation scales, but the local effect is not maintained for a longer period. Keywords: toxinum botulinum type A, Xeomin, Dysport, spasticity

Efficiency of Different Preparations of Botulinum Toxin Type A, Xeomin and Dysport, in the Management of Spastic Upper Limb After Stroke

2019 ◽  
Vol 70 (10) ◽  
pp. 3490-3494
Author(s):  
Marius Nicolae Popescu ◽  
Razvan Cosmin Petca ◽  
Cristina Beiu ◽  
Mihai Cristian Dumitrascu ◽  
Aida Petca ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Local Effect ◽  
National Agency ◽  
Good Efficiency ◽  
Upper Limb Function ◽  
Higher Doses

The present study quantifies the effect of the two botulinum toxin type A products, Xeomin and Dysport, with approval from the National Agency for Medicines and Medical Devices of Romania (ANMDMR), for the treatment of the spastic upper limb following a stroke. The results obtained in the present study show a good efficiency of using both products in the spasticity of the upper limb, and a maintenance of the results obtained for both products for a minimum period of 3 months. Also, at higher doses, the results of the study show better improvement of spasticity and upper limb function on the evaluation scales, but the local effect is not maintained for a longer period.

scholarly journals Botulinum Toxin Type A Injections as Monotherapy for Upper Limb Essential Tremor Using Kinematics

2017 ◽  
Vol 45 (1) ◽  
pp. 11-22 ◽  
Author(s):  
Olivia Samotus ◽  
Niraj Kumar ◽  
Philippe Rizek ◽  
Mandar Jog
Keyword(s):  
Botulinum Toxin ◽  
Essential Tremor ◽  
Upper Limb ◽  
Rating Scale ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Functional Improvement ◽  
Motion Sensors ◽  
Dosing Patterns

AbstractBackground:There is a significant need for a targeted therapy for essential tremor (ET), as medications have not been developed specifically for ET, and the ones prescribed are often not well-tolerated, so that many patients remain untreated. Recent work has shown that, unlike previous experience, kinematically guided individualized botulinum toxin type A (BoNT-A) injections provide benefit along with minimal weakness. Ours is the first long-term (96-week) safety and efficacy study of BoNT-A as monotherapy for ET using kinematically driven injection parameters.Methods:Ten ET patients were administered six serial BoNT-A treatments every 16 weeks and were assessed at 6 weeks following treatment. During each study visit, the Fahn–Tolosa–Marin (FTM) scale, the Unified Parkinson’s Disease Rating Scale, and the Quality of Life for Essential Tremor Questionnaire (QUEST) were administered along with kinematic assessment of the treated limb. Participants performed scripted tasks with motion sensors placed over each arm joint. Dosing patterns were determined using the movement disorder neurologist’s interpretation of muscles contributing to the kinematically analyzed upper limb tremor biomechanics.Results:There was a 33.8% (p<0.05) functional improvement (FTM part C) and a 39.8% (p<0.0005) improvement in QUEST score at week 96 compared to pretreatment scores at week 0. Although there was a 44.6% (p<0.0005) non-dose-dependent reduction in maximal grip strength, only 2 participants complained of mild weakness. Following the fourth serial treatment, mean action tremor score was reduced by 62.9% (p=0.001) in the treated and by 44.4% (p=0.03) in the untreated arm at week 96 compared to week 48.Conclusions:Individualized BoNT-A dosing patterns to each individual’s tremor biomechanics provided an effective monotherapy for ET as function improved without functionally limiting muscle weakness.

The Combined Effect of Dynamic Splinting and Neuromuscular Electrical Stimulation in Reducing Wrist and Elbow Contractures in Six Children with Cerebral Palsy

2010 ◽  
Vol 34 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Neil Postans ◽  
Philip Wright ◽  
Will Bromwich ◽  
Ingrid Wilkinson ◽  
Sybil E. Farmer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Range Of Motion ◽  
Upper Limb ◽  
Neuromuscular Electrical Stimulation ◽  
Limb Function ◽  
Upper Limb Function ◽  
Dynamic Splinting

The aim of this pilot study was to investigate the feasibility of applying the combination of Dynamic splinting (DS) and Neuromuscular electrical stimulation (NMES) in order to improve wrist and elbow function, and range of motion, in children with upper limb contractures due to Cerebral palsy (CP). Six children aged seven to 16, with contractures at the wrist or elbow, were recruited. Following a 12-week baseline period all participants underwent a 12-week treatment period where DS was used for one hour per day and combined with NMES for the second half of the 1-h treatment. A 12-week follow-up period then ensued. Upper limb function was assessed with the Melbourne assessment, physical disability with the Paediatric Evaluation of Disability Index and the Activity Scale for Kids, and quality of life with the Pediatric Quality of Life Scale. Passive and active range of motion at the wrist and elbow were measured using manual and electrical goniometers. The technique of using combined NMES and DS was demonstrated to be feasible and compliance with the intervention was good. There was an increase in passive elbow extension in two participants treated for elbow contractures, although no accompanying change in upper limb function was demonstrated. Wrist range of movement improved in one participant treated for wrist contracture.

scholarly journals Effect of Baseline Spastic Hemiparesis on Recovery of Upper-Limb Function Following Botulinum Toxin Type A Injections and Postinjection Therapy

2009 ◽  
Vol 90 (9) ◽  
pp. 1462-1468 ◽  
Author(s):  
Chia-Lin Chang ◽  
Michael C. Munin ◽  
Elizabeth R. Skidmore ◽  
Christian Niyonkuru ◽  
Lynne M. Huber ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Limb Function ◽  
Spastic Hemiparesis ◽  
Upper Limb Function
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