Effect of Upper Limb Botulinum Toxin Injections on Impairment, Activity, Participation, and Quality of Life Among Stroke Patients

Abstract

BACKGROUND AND PURPOSE: The purpose of this study was to study the effect of Botulinum toxin type A (BoNT-A) injections in spastic upper limb muscles on impairment, activity, participation and quality of life in chronic stroke patients. METHODS: BoNT-A (Dysport) was injected into several upper limb spastic muscles in a group of 20 patients. Neurological impairment (muscle tone and strength, dexterity, SIAS), activity (ABILHAND), participation (SATIS-Stroke), and quality of life (SF36) were assessed before and 2 months after the injections. RESULTS: BoNT-A injections improved muscle tone, but had no impact on dexterity, manual ability, social participation, and quality of life. CONCLUSIONS: In this study, BoNT-A injections in spastic upper limbs significantly reduced neurological impairments, but had no functional impact.

Post-Stroke Focal Hand Dystonia

“…Caty et al did a study on the effect of botox on impairment, activity participation and quality of life and although reported increased effect of botox on tone but has shown no improvement in quality of life among patients with focal dystonia of hand. 18 Their results are not in accordance with the results of the current study. This contradiction might have occurred as they have used only botox in their study without focusing on the effectiveness of exercise in their study and in current study both botox and task specific exercises were used for treatment.…”

The Effect of Vibratory Stimulation on Tissue Compliance and Muscle Activity in Elbow Flexor Spasticity

“…Quadriplegia and muscular weakness are associated with spasticity and also affect motor function. Patients with spasticity experience serious deterioration in quality of life and social participation 3) . Thus, various clinical methods to control spasticity are being attempted.…”

Does Spasticity Reduction by Botulinum Toxin Type A Improve Upper Limb Functionality in Adult Post-Stroke Patients? A Systematic Review of Relevant Studies

“…Spasticity is only one among several clinical signs of well-known upper motor neuron (UMN) syndrome following cerebral lesion and characterized by positive and negative symptoms. Someone hypothesizes that spasticity does not contribute to the limitation of function and that the underlying weakness is the only significant cause of activity limitation [5,23,57,58]. Thereby, a key role could be represented by residual active movement in affected arm.…”

“…Several functional limitations arise from spasticity including impaired movement, hygiene, self-care, poor self-esteem, body image, pain and pressure ulcers that increase carer burden. Furthermore, patients with severe spasticity can develop poor social participation and quality of life (QOL) [5]. Because of these concerns and related high social costs [6], many therapeutic strategies have been proposed for the treatment of this disorder including surgical, medical and rehabilitative procedures.…”