BOTULINUM TOXIN AND TASK SPECIFIC TRAINING

Abstract

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.