• So Young Lee, Young Tae Jeon, Bo Ryun Kim, and Eun Young Han.
• Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea.
• Medicine (Baltimore). 2017 Dec 1; 96 (51): e9468.

RationaleSpasticity is a major complication after stroke, and botulinumtoxin A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve voluntary motor control or activities of daily living function of paretic upper limbs. This study investigated whether BoNT-A injection combined with robot-assisted upper limb therapy improves voluntary motor control or functions of upper limbs after stroke.Patient ConcernsTwo subacute stroke patients were transferred to the Department of Rehabilitation.DiagnosesPatients demonstrated spasticity in the upper extremity on the affected side.InterventionsBoNT-A was injected into the paretic muscles of the shoulder, arm, and forearm of the 2 patients at the subacute stage. Conventional rehabilitation therapy and robot-assisted upper limb training were performed during the rehabilitation period.OutcomesManual dexterity, grip strength, muscle tone, and activities of daily living function were improved after multidisciplinary rehabilitation treatment.LessonsBoNT-A injection in combination with multidisciplinary rehabilitation treatment, including robot-assisted arm training, should be recommended for subacute spastic stroke patients to enhance appropriate motor recovery.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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