• Steven L Wolf, S Byron Milton, Aimee Reiss, Kirk A Easley, Neeta V Shenvi, and Patricia C Clark.
• Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. swolf@emory.edu
• Arch Phys Med Rehabil. 2012 Apr 1; 93 (4): 578-87.

ObjectiveTo determine whether dose-specified botulinum toxin type A (BTX-A) and a standardized exercise protocol produce better upper extremity function than placebo and the same exercise program.DesignDouble-blind randomized trial.SettingA rehabilitation research center.ParticipantsA convenience sample of patients (N=25, age range, 23-76 y) who sustained a stroke 3 to 24 months previously but could initiate wrist extension.InterventionsParticipants were randomly selected to receive either BTX-A (maximum 300 U) or saline, followed by 12 to 16 exercise sessions.Main Outcome MeasuresThe primary outcome was the Wolf Motor Function Test (WMFT). Secondary outcome measures included the Modified Ashworth Scale (MAS), active range of motion, and the Stroke Impact Scale (SIS; quality of life).ResultsThere were no group-by-time interactions for changes in the WMFT and no treatment difference (P=.86), although the BTX-A group could complete more tasks governing proximal joint motions. MAS scores improved for the BTX-A group and worsened for the control group after injection (P=.02), as did the SIS emotion domain (P=.035).ConclusionsAmong chronic stroke survivors, BTX-A did not impact function, movement, or tone more than a standardized exercise program.Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

31 keywords...

hide…