scholarly journals Evaluating the Effects of Botulinum Toxin Injection and Physiotherapy on Post-Stroke Patients During One Year Observation - a Pilot Study

2021 ◽  
Vol 25 (3) ◽  
Author(s):  
Zuzanna Olszewska ◽  
Elżbieta Mirek ◽  
Kinga Opoka-Kubica ◽  
Szymon Pasiut Szymon Pasiut ◽  
Magdalena Filip
Keyword(s):  
Botulinum Toxin ◽  
Pilot Study ◽  
Combination Therapy ◽  
Upper Limb ◽  
Muscle Tone ◽  
Statistical Significance ◽  
Botulinum Toxin Injection ◽  
Upper Limbs ◽  
Stroke Patients ◽  
Post Stroke

Introduction: Stroke is a serious health problem in the modern population. Spasticity is one of the consequences of stroke and affects about 30% of people. Increased muscle tone affects postural control disorders. Due to the specificity of spasticity, therapy in post-stroke patients is a challenge for neurological physiotherapy. Therefore, it requires the development of appropriate management standards . Study aim: The aim of the study was to evaluate the effectiveness of 3 combination therapy cycles based on botulinum toxin injection and physiotherapy for muscle tone, muscle strength and postural stability in post-stroke patients qualified for the spasticity treatment programme of the lower and upper limbs. Material and methods: The pilot study involved 12 patients (6 from the lower limb and 6 from the upper limb programme). The 1-year combination therapy programmes included 3 botulinum toxin injections and 3 weeks of physiotherapy after each injection. Clinical evaluation was conducted before and after the 1-year observation cycle. The results were evaluated using: MAS (Modified Ashworth Scale), MRC (Medical Research Council Scale) and posture stability test on a balance platform (BiodexSD). Results: A decrease was observed in muscle tone of the lower and upper limbs, as well as an increase in muscular strength of the upper limb. However, there were no noted statistical significance of the studied parameters. Conclusions: Physiotherapy in combination with the botulinum toxin is an important element of improvement in post-stroke patients. However, further research is needed to explicitly confirm its effectiveness.

Music-supported therapy (MST) in improving post-stroke patients' upper-limb motor function: a randomised controlled pilot study

2015 ◽  
Vol 37 (5) ◽  
pp. 434-440 ◽  
Author(s):  
Yanna Tong ◽  
Brian Forreider ◽  
Xinting Sun ◽  
Xiaokun Geng ◽  
Weidong Zhang ◽  
...  
Keyword(s):  
Pilot Study ◽  
Motor Function ◽  
Upper Limb ◽  
Stroke Patients ◽  
Post Stroke ◽  
Randomised Controlled

scholarly journals Wrist Actimetry Biomarker Development of Paretic Upper Limb Use in Post Stroke Patients for Ecological Monitoring.

2021 ◽  
Author(s):  
Gilles Dusfour ◽  
Denis Mottet ◽  
Makii Muthalib ◽  
Isabelle Laffont ◽  
Karima K.A. Bakhti
Keyword(s):  
Home Environment ◽  
Upper Limb ◽  
Healthy Subjects ◽  
Limiting Factors ◽  
Cumulative Probability ◽  
Limiting Factor ◽  
Upper Limbs ◽  
Stroke Patients ◽  
Post Stroke ◽  
Paretic Side

Abstract Background In post-stroke patients it is unclear which wrist actimetry biomarkers to use to estimate the degree of upper limb hemiparesis. The objective of this study was to develop a general and objective framework for monitoring hemiparetic patients in their home environment via different biomarkers based on 7 days of actimetry data. A secondary objective was to use all of these biomarkers to better understand the mechanism for potential non-use of the paretic upper limb. Methods Accelerometers were worn continuously for a period of 7 days on both wrists of 10 post-stroke hemiparetic patients as well as 6 healthy subjects. Various wrist actimetry biomarkers were calculated, including the Jerk ratio 50 (JR50, cumulative probability that the Jerk Ratio is between 0 and 0.5), absolute and relative amounts of functional use of movements of the upper limbs (FuncUse and FuncUseR) and absolute and relative velocities of the upper limbs during functional use (VUL and VULR). For each biomarker, the values of stroke and healthy groups were compared. The correlations between all the biomarkers were studied. Results We studied 10 participants with mild-to-moderate chronic hemiparesis and 6 healthy control participants. FuncUse and VUL of the paretic upper limb of stroke patients were significantly lower than in the non-dominant upper limb of healthy subjects. Similarly, FuncUseR (paretic/non-paretic vs non-dominant/dominant), JR and VULR are significantly lower in stroke patients than in healthy subjects. FuncUseR, VULR and JR50 seem to be complementary biomarkers for monitoring patient strokes. Conclusion The stroke patients do not seem to compensate for the decrease in functional movement on the paretic side by an increase on the non-paretic side. The speed of execution of functional movements on the paretic side could be the limiting factor to a normal use of the paretic upper limb. A thorough clinical study is needed to identify the limiting factors. In conclusion, this study for the first time has shown actimetry is a robust and non-obtrusive lightweight technology for continuously acquiring objective upper limb data of paretic arm use/ non-use over an extended period in a home environment for monitoring stroke patients.

Botulinum Toxin Type A and Post-stroke Spasticity of the Upper Limbs

US Neurology ◽  
2009 ◽  
Vol 05 (01) ◽  
pp. 38
Author(s):  
Cindy B Ivanhoe ◽  
Natasha K Eaddy-Rose ◽  
◽  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Daily Living ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Upper Limbs ◽  
Post Stroke ◽  
The Us ◽  
Developed Nations

Background:Stroke is a significant contributor to morbidity and mortality in the US and other developed nations. Stroke and its side effects are the primary cause of disability in the US and worldwide. Upper limb mobility factors are particularly detrimental to activities of daily living. Successful treatments to improve post-stroke spasticity are required.Objective:To assess the relevant medical literature related to the use of botulinum toxin type A and post-stroke spasticity of the upper limb.Methods:Literature review utilizing Medline with keywords of botulinum toxin, stroke, spasticity, and upper extremity since 2003.Results:Thirteen criteria-based articles investigated botulinum toxin type and poststroke spasticity of the upper limbs. Discussion: Botulinum toxin type A is an effective agent in reducing post-stroke spasticity of the upper limbs.

scholarly journals An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance

2018 ◽  
Vol 5 (9) ◽  
pp. 326-330
Author(s):  
Emre Ata ◽  
Murat Kosem
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Botulinum Toxin Injection ◽  
Stroke Patients ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Limb Muscles ◽  
Botulinum Toxin Injections ◽  
Ashworth Scale ◽  
Electrical Muscle

Objective: This study has aimed to compare the efficacy of botulinum toxin (BTX) injections, applied to the upper limb muscles of the stroke patients in our clinic who have being diagnosed with focal spasticity, that are performed via ultrasonography and ultrasonography + electrical muscle (EM) stimulator guidance. Literature didn’t include detailed crosscheck of ultrasound guided BTX and EM treatment applications for upper limb focal spasticity patients Materials and Methods: Electronic data on 62 hemiplegic stroke patients with grade 2 and 3 focal spasticity who had received botulinum toxin injections into their upper limb muscles by the same physician, who used similar protocol and recorded the results, were scanned retrospectively. The spasticity of the patients in both groups was assessed with the Modified Ashworth Scale at the end of two weeks and three months. Results: A statistically significant difference was found between the Modified Ashworth Scale values of both groups in terms of all muscles, compared to the values seen in the pre-treatment period (p<0.05). The Modified Ashworth Scale values at 3 months posttreatment in ultrasonography + electrical muscle stimulator group were not statistically different from those at 2 weeks posttreatment, with respect to wrist flexion and finger flexion. In intergroup comparison, there was no statistically significant difference between the Modified Ashworth Scale values of at pretreatment and 2 weeks posttreatment. However, statistically significant difference in all muscle groups was found in favor of the ultrasonography + electrical muscle stimulator group at 3 months posttreatment controls (p<0.05). Conclusion: Upper limb spasticity due to stroke can be substantially recovered with botulinum toxin injections that are applied via only ultrasonography guidance or via ultrasonography + electrical muscle stimulator guidance.. According to data from the assessment at 3 months posttreatment, the botulinum toxin injection performed via ultrasonography + electrical muscle stimulator guidance had more positive effects .

Sequentially applied myoelectrically controlled FES in a task-oriented approach and robotic therapy for the recovery of upper limb in post-stroke patients: A randomized controlled pilot study

2020 ◽  
pp. 1-11
Author(s):  
Gloria Perini ◽  
Rita Bertoni ◽  
Rune Thorsen ◽  
Ilaria Carpinella ◽  
Tiziana Lencioni ◽  
...  
Keyword(s):  
Upper Limb ◽  
Standard Care ◽  
Experimental Treatment ◽  
Stroke Patients ◽  
Rehabilitation Care ◽  
Post Stroke ◽  
Robotic Therapy ◽  
Arm Rehabilitation ◽  
Point Increase ◽  
Task Oriented

BACKGROUND: Functional recovery of the plegic upper limb in post-stroke patients may be enhanced by sequentially applying a myoelectrically controlled FES (MeCFES), which allows the patient to voluntarily control the muscle contraction during a functional movement and robotic therapy which allows many repetitions of movements. OBJECTIVE: Evaluate the efficacy of MeCFES followed by robotic therapy compared to standard care arm rehabilitation for post-stroke patients. METHODS: Eighteen stroke subjects (onset ⩾ 3 months, age 60.1 ± 15.5) were recruited and randomized to receive an experimental combination of MeCFES during task-oriented reaching followed by robot therapy (MRG) or same intensity conventional rehabilitation care (CG) aimed at the recovery of the upper limb (20 sessions/45 minutes). Change was evaluated through Fugl-Meyer upperextremity (FMA-UE), Reaching Performance Scale and Box and Block Test. RESULTS: The experimental treatment resulted in higher improvement on the FMA-UE compared with CG (P= 0.04), with a 10 point increase following intervention. Effect sizes were moderate in favor of the MRG group on FMA-UE, FMA-UE proximal and RPS (0.37–0.56). CONCLUSIONS: Preliminary findings indicate that a combination of MeCFES and robotic treatment may be more effective than standard care for recovery of the plegic arm in persons > 3 months after stroke. The mix of motor learning techniques may be important for successful rehabilitation of arm function.

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