A Pilot Randomized Controlled Trial of Botulinum Toxin Treatment Combined with Robot-Assisted Therapy, Mirror Therapy, or Active Control Treatment in Patients with Spasticity Following Stroke.

Abstract	Effects of the combined task-oriented trainings with botulinum toxin A (BoNT-A) injection on improving motor functions and reducing spasticity remains unclear. This study aims to investigate effects of 3 task-oriented trainings (robot-assisted therapy (RT), mirror therapy (MT), and active control treatment (AC)) in patients with stroke after BoNT-A injection. Thirty-seven patients with chronic spastic hemiplegic stroke were randomly assigned to receive RT, MT, or AC following BoNT-A injection over spastic upper extremity muscles. Each session of RT, MT, and AC was 75 min, 3 times weekly, for 8 weeks. Outcome measures were assessed at pretreatment, post-treatment, and 3-month follow-up, involving the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), Motor Activity Log (MAL), including amount of use (AOU) and quality of movement (QOM), and arm activity level. All 3 combined treatments improved FMA, MAS, and MAL. The AC induced a greater effect on QOM in MAL at the 3-month follow-up than RT or MT. All 3 combined trainings induced minimal effect on arm activity level. Our findings suggest that for patients with stroke who received BoNT-A injection over spastic UE muscles, the RT, MT, or AC UE training that followed was effective in improving motor functions, reducing spasticity, and enhancing daily function.
Authors	Jen-Wen Hung, Chu-Ling Yen, Ku-Chou Chang, Wei-Chi Chiang, I-Ching Chuang, Ya-Ping Pong, Wen-Chi Wu, Ching-Yi Wu
Journal	Toxins (Toxins (Basel)) Vol. 14 Issue 6 (06 17 2022) ISSN: 2072-6651 [Electronic] Switzerland
PMID	35737076 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References	Botulinum Toxins, Type A
Topics	Botulinum Toxins, Type A (therapeutic use) Humans Mirror Movement Therapy Muscle Spasticity (drug therapy, etiology) Pilot Projects Robotics Stroke (complications, drug therapy) Stroke Rehabilitation Treatment Outcome Upper Extremity

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