Toxin injections prove useful for spasticity after stroke

olunteers were randomized to either a placebo group or a group receiving one-time injections of 200 to 240 units of botulinum toxin type A.

The volunteers were asked to select one of four areas of disability as the principal target of treatment. That area was rated as moderate to severe on a four-point scale for determining degree of disability. The areas targeted for treatment by the patient pertained to perceived disability caused by the spasticity. They were personal hygiene, dressing, pain or limb position all of which can be affected by a spastic or "frozen" limb. The rating was done at the initiation of the trial and at six weeks, at which time 40 of the 64 participants in the botulinum toxin type A group reported improvement in the selected area of disability. In the placebo group only 17 of the 62 participants reported improvement.

Significant improvement in wrist and finger flexors was observed in the majority of patients one week after the injection. The improvement was sustained at the 12-week follow-up. Participants also showed no adverse reactions to the botulinum toxin type A injections.

Following the conclusion of their participation in the clinical trial, 111 of the 126 participants volunteered to receive up to three additional treatments and each set of injections had positive effects that lasted for at least 12 weeks and, in some cases, as long as 18 to 24 weeks, the study reports.

"The findings suggest that botulinum toxin is useful in improving muscle tone, function and quality of life in patients with wrist and finger spasticity after a stroke," Dr. Brashear concludes.


Contact: Mary Hardin
Indiana University

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