Objective assessment of cortical activity changes in stroke patients before and after hand rehabilitation with and without botulinum toxin injection

Omnia A Abu-Bakr,Eman A Tawfik,Amal M Al-Ganzoury,Nagwaa M M Nassar,Khaled Abo-Elfotouh Ahmed

doi:10.4103/err.err_38_16

Omnia A Abu-Bakr, Eman A Tawfik + Show 3 more

Open Access

https://doi.org/10.4103/err.err_38_16

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Abstract

BackgroundUpper limb spasticity is a disabling condition and may result in severe functional limitation. The peripheral action of botulinum toxin (BTX) injection on spasticity is well known, but there are debates around its possible central action.AimThe aim of this study was to assess the clinical, functional, and cortical activation outcome of two antispastic treatments for stroke of the hand and wrist. Thirty patients with upper limb poststroke spasticity were recruited in this study.Patients and methodsThey were randomly allocated to two groups: group A and group B. Both groups received rehabilitation program, whereas group B received additional BTX injection. All patients were assessed at baseline and 8 weeks after treatment using the Modified Ashworth Scale, the Action Research Arm Test and Nine-Hole Peg Test, and somatosensory-evoked potential study of the median nerve.ResultsGroup B showed a higher percentage of change in Modified Ashworth Scale of the wrist flexors and long flexors of fingers and in Action Research Arm Test compared with group A.ConclusionBTX injection in spastic muscles of the wrist and hand, followed by a rehabilitation program led to greater clinical and functional improvement compared with implementing the rehabilitation program alone.

Highlights

Upper limb spasticity can be disabling and can result in several functional limitations
Patients with any of the following conditions were excluded from the study: Somatosensory-evoked potential (SEP) studies in patients with spasticity showed improvement in SEP following botulinum toxin (BTX) injection, which may support the possible central action of BTX in the cerebral cortex [2,3]
Thirty patients with upper limb poststroke spasticity were included in this study

Summary

Introduction

Upper limb spasticity can be disabling and can result in several functional limitations. Upper limb spasticity is a disabling condition and may result in severe functional limitation. Thirty patients with upper limb poststroke spasticity were recruited in this study. Patients and methods They were randomly allocated to two groups: group A and group B. Both groups received rehabilitation program, whereas group B received additional BTX injection. All patients were assessed at baseline and 8 weeks after treatment using the Modified Ashworth Scale, the Action Research Arm Test and Nine-Hole Peg Test, and somatosensory-evoked potential study of the median nerve

Results

Discussion

Conclusion