Do stroke survivors with upper extremity spasticity benefit from botulinum toxin? An observational study exploring daily activities

[摘要] PURPOSE: To explore the benefit of routine botulinum toxin A (BoNT-A) treatment for the daily activities of stroke survivors with upper extremity spasticity and to facilitate 'patient-centred' and daily life-oriented spasticity management. METHODS: A quantitative observational study over one injection cycle performed in a German spasticity outpatient clinic. Participants (n=27) were assessed at baseline (T0), 4-6 (Tmax1) and 12-14 weeks (T2) after injection. Primary outcome measures were Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling (GAS) and Arm Activity Measure (ArmA). Secondary measures included Resistance to Passive Movement Scale (REPAS), Motricity Index (MI), SF-12v2 Health Survey, Global Clinical Impression (GCI) and importance and satisfaction. RESULTS: Significant improvements were observed from T0 to Tmax1 and T0 to T2, but not from Tmax1 to T2 for COPM, ArmA part A and REPAS. Goals were attained by 33.3% of participants. Importance and satisfaction with the treatment was high. GCI was rated "good" to "very good" by 45.8% to 75%. ArmA part B, MI and SF-12v2 showed no change. CONCLUSIONS: Routine BoNT-A treatment with outpatient therapy improved daily activities, being clinically significant for up to 50% of participants. ArmA and COPM are suitable measures to facilitate 'patient-centred' and daily life-focused routine spasticity management.

[发布机构] University:University of Birmingham;Department:School of Sport, Exercise and Rehabilitation Sciences

[关键词] R Medicine;RC Internal medicine