Article

OBJECTIVE: To 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. DESIGN: Double-blind randomized trial.
SETTING: A rehabilitation research center. PARTICIPANTS: A 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. INTERVENTIONS: Participants were
randomly selected to receive either BTX-A (maximum 300 U) or saline, followed by
12 to 16 exercise sessions.
MAIN OUTCOME MEASURES: The 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). RESULTS:
There 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). CONCLUSIONS: Among chronic stroke survivors,
BTX-A did not impact function, movement, or tone more than a standardized
exercise program.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS