QUANTIFICATION OF FUNCTIONAL CHANGE AFTER TEMPORARY CHEMONEUROLYTIC INTERVENTION IN ANKLE SPASTICITY

Abstract

subscapularis. Primary outcomes were pain measured by visual analog scale (VAS), physician global rating scale (PGRS), and measurement of range of motion (ROM) using goniometry. Secondary outcomes were arm function measured by the Fugl-Meyer score, and spasticity measured by modified Ashworth scale. Measurements were made at baseline and 2and 6-, and 12-wk after the injection by blinded evaluator. Result: At 12-wk post treatment the mean decrease in pain in the BoNT-A treated group was 5.4 vs. 2.3 in the triamcinolone group (P 0.05). Improvement in physician rating scale was 2.4 vs. 1.6 (P 0.05). The net change in the Fugl-Meyer score was significantly greater in the BoNT-A group than the triamcinolone group (14.7 vs. 2.1, P 0.05). However, there were no differences between treatment modalities with respect to changes in ROM and modified Ashworth scale at 12 wk. There were no observed side effects in either treatment group. Conclusion: Injection of BoNT-A into selected muscles of the shoulder girdle provided sustained and more significant relief of shoulder pain and improved function than intraarticular injection of triamcinolone acetonide.