Article

PURPOSE: To compare the effects of botulinum toxin injection with and without
needle electromyographic guidance for the treatment of spasticity. METHOD: A
randomized controlled study was conducted in a tertiary university hospital.
Twenty-seven adult hemiplegic patients with spasticity due to brain or spinal
cord damage were included. Spastic muscles were injected with botulinum toxin
with or without EMG guidance. The modified Ashworth scale and modified Barthel
index in each patient pre- and post-injection were documented. RESULTS: In group
A, which consisted of 15 patients (55.55%), the injection was administered with
needle electromyographic guidance, while in 12 patients (44.44%) of group B
without electromyographic guidance with the use of anatomic landmarks only. The
follow-up period was 3 months. At 3 weeks post-injection, spasticity was
decreased (p < 0.05) in all patients and the mean (SD) reduction of spasticity
was higher (p < 0.05) in group A (1.67 (0.5)) than group B (1.25 (0.46)).
Similarly, the mean (SD) functional modified Barthel index improved statistically
significantly (p < 0.001) post-injection (45.37 (8.43)) than pre-injection (54.07
(9.610), especially in group A (p < 0.05). CONCLUSION: The effectiveness of
intramuscular botulinum toxin injection for the treatment of spasticity in
hemiplegic patients is superior when performed with needle electromyographic
guidance than without electromyography. REHABILITATION: It is
recommended that botulinum toxin muscle injections of hemiplegic limbs be
performed with EMG guidance More spasticity reduction and functional improvement
at 3 months post-injection was observed in patients injected with botulinum toxin
by the use of combined EMG guidance and anatomic landmarks EMG guidance might
also save amount of botulinum toxin due to less spasticity observed during
injection than when injection is performed with anatomic landmarks only.

Langue : ANGLAIS