• Zhang-Xiang Wu, Chao Wang, Zheng Huang, Xue-Han Liu, and Mei Shen.
• Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Affiliated Hospital of Guangdong Medical University.
• Medicine (Baltimore). 2021 Apr 9; 100 (14): e25252e25252.

RationaleWrist-hand extension function rehabilitation is a vital and difficult part of hand function recovery in spastic stroke patients. Although botulinum toxin type A (BoNTA) injection plus post injection therapy was applied to the wrist-hand rehabilitation in previous reports, conclusion was inconsistent in promoting function. For this phenomenon, proper selection of patients for BoNTA injection and correct choice of post-injection intervention could be the crucial factors for the function recovery.Patient ConcernsWe reported a 46-year-old male suffered a spastic hemiplegia with wrist- hand extension deficit.DiagnosesComputed tomography showed cerebral hemorrhage in the left basal ganglia region.InterventionsFour hundred units of BoNTA were injected into the spasticity flexors, and four-week post injection surface electromyography (sEMG) biofeedback therapy was applied to the patient.OutcomesThe patient exhibited post-intervention improvement in wrist-hand extensors performance (strength, range of motion, sEMG signals), the flexors spasticity, and upper extremity function.LessonsThe present case showed that 4-week of BoNTA injection plus sEMG biofeedback exercise improved the performance and function of wrist-hand extensors in the patient for short- and long-term. Proper selection of patients for BoNTA injection and correct choice of post injection exercise could play a vital role in the hand rehabilitation for patient with spastic hemiplegia.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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