Article

This study aimed to provide clinical injection data and real-world
patient-reported and clinical outcomes for the chemodenervation and neurolytic
treatment of muscle overactivity including spasticity in patients with traumatic
brain injury and stroke. DESIGN: This study used a prospective multicenter
observational design. The participants were 487 patients with stroke or traumatic
brain injury. The interventions used were onabotulinumtoxin A or phenol. Nine
subjects received both onabotulinumtoxin A and phenol. The main outcome measures
were satisfaction and goal attainment, pain, and Ashworth Scale scores. RESULTS:
The most commonly treated pattern of dysfunction in the upper limb was the flexed
wrist, with the flexor carpi radialis as the most frequently treated muscle. The
mean total dose for the upper limb muscle was 57.7 +/- 34.1 U, and phenol volume
was 3.9 +/- 0.7 ml. The most commonly treated pattern of dysfunction in the lower
limb was the equinovarus/equinus foot, with the medial/lateral gastrocnemius as
the most frequently treated muscles. The mean total dose for the lower limb
muscle was 93.8 +/- 63.5 U, and phenol volume was 4.1 +/- 1.3 ml. There was a
significant improvement in Ashworth Scale and pain scores. Generally, the
patients reported that they were satisfied with their treatment and made progress
toward their goals. No significant treatment-related adverse effects were
reported. CONCLUSIONS: Based on 487 patients with stroke and traumatic brain
injury who were selected by their physician and clinical presentation for
treatment using chemodenervation and neurolysis, this report of injection data
reflecting actual clinical practice may serve as a further clinical guide in the
management of patients with muscle overactivity, including spasticity.

Langue : ANGLAIS