Article

OBJECTIVE: To compare the effectiveness of two procedures increasing the
botulinum toxin type A effect for wrist and finger flexor spasticity after
stroke. DESIGN: A single-blind randomized trial. SUBJECTS: Seventy patients with
upper limb post-stroke spasticity. 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. 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). 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.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS