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Abstract
Objective: This study aimed to determine if ultrasonography and electrical muscle stimulation-guided botulinum toxin injection into the upper extremity muscles increases the efficacy of the treatment of focal spasticity in patients with chronic stroke. Materials and Methods: This study included 22 chronic hemiplegic stroke patients with grade 2 and 3 spasticity in the upper extremity muscles, based on the Modified Ashworth Scale. The study hypothesis was that ultrasonography and electrical muscle stimulation-guided botulinum toxin injection would increase the efficacy of the treatment of spasticity. The Modified Ashworth Scale, Tardieu Scale, Barthel Index and Fugl-Meyer Motor Assessment Scale were administered at baseline, and at 2 weeks and 2 months post treatment. Results: All parameters were improved significantly at 2 weeks post treatment, as compared to baseline, and the observed improvement persisted at 2 months post treatment (P < 0.05). Conclusion: Ultrasonography and electrical muscle stimulation-guided botulinum toxin injection significantly improved spasticity and functional recovery in chronic stroke patients with upper extremity spasticity.
Highlights
Spasticity is a cause of disability in 38% of stroke patients during the first year post stroke [1]
The present study aimed to determine if US and electrical muscle stimulation (EMS)-guided Botulinum toxin (BTX) injection into the upper extremity muscles increases the efficacy of the treatment of focal spasticity in patients with chronic stroke
The present findings show that significant improvement in spasticity and functional recovery was achieved using dualguided BTX injection (US and EMS) for the treatment of upper extremity spasticity in chronic hemiplegic stroke patients
Summary
Spasticity is a cause of disability in 38% of stroke patients during the first year post stroke [1]. Botulinum toxin (BTX) injection is a safe, effective, and commonly used method for the treatment of focal and multifocal spasticity. Correct muscle group selection and injection technique are the primary factors associated with successful treatment. BTX is reported to be most effective when injected correctly and into the deep-seated motor end plates in muscles [3]. Intramuscular BTX injection can be performed using several types of guidance, including manual needle placement (MNP), electromyography (EMG), electrical muscle stimulation (EMS), and ultrasonography (US). EMS- or US-guided injection is recommended, especially for deep-seated and small muscles [4,5,6]. The present study aimed to determine if US and EMS-guided BTX injection into the upper extremity muscles increases the efficacy of the treatment of focal spasticity in patients with chronic stroke
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