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Experienced consequences of spasticity and effects of botulinum toxin injections: a qualitative study amongst patients with disabling spasticity after stroke.
- Source :
- Disability & Rehabilitation; Dec 2021, Vol. 43 Issue 25, p3688-3695, 8p
- Publication Year :
- 2021
-
Abstract
- Chronic spasticity poses a major burden on patients after stroke. Intramuscular botulinum toxin injections constitute an important part of the treatment for patients suffering from troublesome focal spasticity. This study explores the experienced consequences of chronic spasticity amongst patients after stroke regarding physical impairments and activities, the experienced effects of botulinum toxin treatment on these domains, and whether current spasticity management addresses patients' needs. Fourteen participants with chronic spasticity after stroke who were treated with cyclical botulinum toxin injections in the upper and/or lower extremity muscles were interviewed. Inductive thematic analysis generated representative themes. Analyses of the interviews revealed three themes: (1) spasticity-related impairments and activity limitations; (2) fluctuations in spasticity related to botulinum toxin; (3) need for professional support and feedback. Besides motor impairments, participants experienced activity limitations in many domains of everyday life, with considerable day-to-day fluctuations. Moreover, treatment with botulinum toxin led to cyclical fluctuations in spasticity-related symptoms, which differed across participants. The participants called for shared responsibility for treatment, particularly regarding optimising the timing of injections. Incorporating patient-relevant outcomes into the current assessment of spasticity and monitoring these outcomes may improve spasticity management, particularly regarding the timing of botulinum toxin injections. Because chronic spasticity after stroke impacts on almost all domains of everyday life, professionals should identify and target the most relevant problems in each individual patient. Monitoring patient-reported outcomes may help patients and professionals to get insight in the fluctuations of spasticity-related symptoms and may help to evaluate the effects of botulinum toxin injections from the patient's perspective. Patient education and providing insight in the fluctuations of spasticity-related symptoms may support self-management and shared decision-making in spasticity management. [ABSTRACT FROM AUTHOR]
- Subjects :
- BOTULINUM toxin
STROKE
SKELETAL muscle
SOCIAL support
EXTREMITIES (Anatomy)
RESEARCH methodology
ACTIVITIES of daily living
HEALTH outcome assessment
INTERVIEWING
MOVEMENT disorders
TREATMENT duration
SPASTICITY
INTRAMUSCULAR injections
PHYSICAL activity
QUALITATIVE research
EXPERIENCE
RESPONSIBILITY
PATIENTS' attitudes
STROKE patients
DECISION making
QUALITY of life
NEEDS assessment
THEMATIC analysis
DATA analysis software
DISEASE complications
EVALUATION
SYMPTOMS
Subjects
Details
- Language :
- English
- ISSN :
- 09638288
- Volume :
- 43
- Issue :
- 25
- Database :
- Complementary Index
- Journal :
- Disability & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 154141188
- Full Text :
- https://doi.org/10.1080/09638288.2020.1746843