scholarly journals POST-STROKE FOCAL HAND DYSTONIA

2018 ◽  
Vol 25 (02) ◽  
pp. 205-210
Author(s):  
Muhammad Umar ◽  
Tahir Masood ◽  
Mazhar Badshah

Objectives: To determine the effects of Botulinum toxin A (BoNTA) with taskspecific training on hand function and quality of life in patients with post stroke focal dystonia ofhand. Study Design: Randomized Controlled Trial. Place and Duration of Study: This studywas conducted in Holy family hospital, The Neurocounsel and Chambeli Rehabilitation centerfrom October 2015 to September 2016. Methodology: Both male and female patients sufferingfrom stroke for at least 6 months with focal hand dystonia were included in this randomizedcontrolled trial. 46 patients were recruited in the study through non probability purposivesampling and then were allocated to control (n=23) and experimental group (n=23) by randomnumber list generated for 46 patients using SPSS software. Control group was provided withonly task specific training while experimental group was provided with an injection of BotulinumToxin A in addition to task-specific training. Data was collected from both groups at baselineand then after 8 weeks by using Action Research Arm Test (ARAT), Stroke specific qualityof life (SS-QOL) and Arm dystonia disability scale (ADDS). Results: Although both groupsshowed significant improvements after training(P value <0.001) in both ARAT scale and SSQOLbut as shown by the difference of means of the groups, experimental group has shownmore improvement than control group at the end of 8 weeks of intervention with P value<0.05.ADDS has also shown better results in reducing disability in experimental group as compared tocontrol group. Conclusion: Botulinum toxin A prior to start of task specific training significantlyimproves outcome in post stroke focal hand dystonia patients than task specific training alone.

Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 556-562
Author(s):  
Natasha A. Lannin ◽  
Louise Ada ◽  
Coralie English ◽  
Julie Ratcliffe ◽  
Steven G. Faux ◽  
...  

Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results— In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions— Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000616572.


2016 ◽  
Vol 59 ◽  
pp. e142
Author(s):  
Marjorie Kerzoncuf ◽  
Laurent Bensoussan ◽  
Jean Michel Viton ◽  
Alain Delarque ◽  
Christiane Rossi Durand

2020 ◽  
Vol 3 (1) ◽  
pp. 1-4
Author(s):  
Lin JM ◽  
◽  
Hui Chen ◽  
Liu QL ◽  
Huang MP ◽  
...  

Objective: To evaluate the d the safety and efficacy of 200 U vs. 300 U botulinum toxin A (BTX-A) injections for patients with neurogenic detrusor overactivity (NDO) secondary to spinal cord injury (SCI). Methods: We retrieved the data for the patients who receive a single dose into the detrusor of BTX-A (300 U or 200 U). The clinical outcome included maximum detrusor pressure (Pdetmax) during cystometry, voiding volume, urinary incontinence (UI) episodes between CICs per 24 hour, and complete dryness. Related adverse events were recorded. Results: From July 2015 to June 2017, 28 cases received 300 U BTX-A injections (experiment group) while 19 cases received 200U BTX-A injections (control group). There were no significant differences in baseline evaluation items (gender, age, duration of spinal cord injury, level of neurological injury, AIS scores) between the two groups. There were significant improvement in Pdetmax, UI and I-QoL from baseline in the two groups. Patients in experiment group had statistically greater improvement than those in the control group for Pdetmax (-32.09 cm H2O vs. -28.02 cm H2O, P = 0.016), mean urinary incontinence episodes (-6.18/d vs. -5.01/d, P = 0.042), complete dryness (11 vs. 2, P = 0.031), mean voiding volume (160.52 ml vs. 133.66 ml, P <0.001), and I-QoL (28.53 vs. 20.41, P <0.001). Conclusion: Preliminary results indicate that 300 U BTX-A is more effective than 200 U BTX-A for SCI patients with NDO.


Toxins ◽  
2013 ◽  
Vol 5 (5) ◽  
pp. 983-991
Author(s):  
Woo-Jin Kim ◽  
Witsanu Kumthornthip ◽  
Byung Oh ◽  
Eun Yang ◽  
Nam-Jong Paik

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