Further Assessment to Determine the Additive Effect of Botulinum Toxin Type A on an Upper Extremity Exercise Program to Enhance Function Among Individuals With Chronic Stroke but Extensor Capability
Archives of Physical Medicine and Rehabilitation, 04/12/2012
Among chronic stroke survivors, botulinum toxin type A (BTX–A) did not impact function, movement, or tone more than a standardized exercise program. Methods A convenience sample of patients (N=25, age range, 23–76y) who sustained a stroke 3 to 24 months previously but could initiate wrist extension. Participants were randomly selected to receive either BTX-A (maximum 300U) or saline, followed by 12 to 16 exercise sessions. The primary outcome was the Wolf Motor Function Test (WMFT). Secondary outcome measures included the Modified Ashworth Scale (MAS), active range of motion, and the Stroke Impact Scale (SIS; quality of life). Results
There were no group-by-time interactions for changes in the WMFT and no treatment difference (P=.86), although the BTX-A group could complete more tasks governing proximal joint motions. MAS scores improved for the BTX-A group and worsened for the control group after injection (P=.02), as did the SIS emotion domain (P=.035).