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Adhesive taping vs. daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial.
- Source :
-
Clinical rehabilitation [Clin Rehabil] 2015 Jan; Vol. 29 (1), pp. 50-8. Date of Electronic Publication: 2014 Jun 10. - Publication Year :
- 2015
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Abstract
- Objective: To compare the effectiveness of two procedures increasing the botulinum toxin type A effect for wrist and finger flexor spasticity after stroke.<br />Design: A single-blind randomized trial.<br />Subjects: Seventy patients with upper limb post-stroke spasticity.<br />Methods: Adults with wrist and finger flexor muscles spasticity after stroke were submitted to botulinum toxin type A therapy. After the treatment, the subjects injected were randomly divided into two groups and submitted to adhesive taping (Group A) or daily muscle manual stretching, passive articular mobilization of wrist and fingers, and palmar splint (Group B) for 10 days. We measured spasticity with Modified Ashworth Scale, related disability with Disability Assessment Scale, and fingers position at rest. The measurements were done at baseline, after two weeks, and after one month from the treatment session.<br />Results: After two weeks, subjects in Group A reported a significantly greater decrease in spasticity scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.3±0.6 vs. 2.1±0.6; Modified Ashworth Scale wrist: 1.7 ±0.6 vs. 2.3 ±0.8), and after one month in spasticity and disability scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.9 ±0.7 vs. 2.5 ±0.6; Modified Ashworth Scale wrist: 2.0 ±0.7 vs. 2.6 ±0.6; Disability Assessment Scale: 1.6 ±0.7 vs. 2.1 ±0.7) compared with Group B subjects. Subjects in Group A reported also a significantly improved fingers position at rest compared with Group B subjects after two weeks (2.8 ±0.9 vs. 2.1 ±0.7) and one month (2.3 ±0.7 vs. 1.5 ±0.6).<br />Conclusions: Adhesive taping of wrist and finger flexor muscles appeared to enhance the effect of botulinum toxin type A therapy more than daily manual muscle stretching combined with passive articular mobilization and palmar splint.<br /> (© The Author(s) 2014.)
- Subjects :
- Botulinum Toxins, Type A pharmacokinetics
Botulinum Toxins, Type A therapeutic use
Female
Fingers physiopathology
Humans
Injections, Intramuscular
Italy
Male
Middle Aged
Muscle Spasticity drug therapy
Muscle Spasticity etiology
Neuromuscular Agents administration & dosage
Neuromuscular Agents pharmacokinetics
Neuromuscular Agents therapeutic use
Outcome and Process Assessment, Health Care
Single-Blind Method
Stroke complications
Wrist Joint drug effects
Wrist Joint physiopathology
Bandages
Botulinum Toxins, Type A administration & dosage
Muscle Spasticity rehabilitation
Muscle Stretching Exercises methods
Splints
Stroke Rehabilitation
Subjects
Details
- Language :
- English
- ISSN :
- 1477-0873
- Volume :
- 29
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Clinical rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 24917588
- Full Text :
- https://doi.org/10.1177/0269215514537915