Effect of botulinum toxin type-A in patients with focal spasticity

• Published in: Northern clinics of Istanbul Vol. 1; no. 3; pp. 153 - 157
• Main Authors: Selimoglu, Esra, Turgut, Selin Turan, Akpinar, Pinar, Yumusakhuylu, Yasemin, Haliloglu, Sema, Baklacioglu, Hatice Sule, Icagasioglu, Afitap
• Format: Journal Article
• Language: English
• Published: Turkey Kare Publishing 01.01.2014
• Subjects: Original; Botulinum toxin type-A; spasticity; hemiplegia; cerebral plasy
• ISSN: 2536-4553; 2148-4902; 2536-4553
• DOI: 10.14744/nci.2014.43531

To investigate the effect of botulinum toxin type-A (BTX-A) on spasticity and function in patients with focal spasticity. Patients attended to the outpatient clinic of physical medicine and rehabilitation department with a diagnosis of focal spasticity and had BTX-A injections because of spasticty were evaluated for the study. Demographic data, exercise status, orthoses, drugs used for spasticity, functional status, stages of spasticity of muscles before and after 1 and 3 months of BTX-A injection according to Modified Ashworth Scale (MAS) were evaluated retrospectively. MedCalc 11.6 statistical program was used for statistical analyses. Statistical significance was defined as p<0.05. Forty-nine patients with focal spasticity were recruited for the study (35 men, 14 women). Mean age of the patients was 21.59±20.09 years. The patients had cerebral palsy (CP, n=28), 19 had hemiplegia (n=19) and paraplegia (n=2). Forty-three patients were using orthoses and exercising regularly. Mean Pediatric Functional Independence Measurement (WeeFIM) scores of the patients with CP was 54.82±28.91 and according to the Gross Motor Function Classification System (GMFCS) the patients were in stages 2 (14%), 3 (46%), 4 (11%) and 5 (29%). Mean Functional Independence Measure (FIM) of hemiplegic and paraplegic patients was 80.80±20.88. Brunnstrom staging scores for upper extremity (3.52±0.96), hands (2.68±0.82), lower extremity (4.57±1.01) were calculated. MAS muscles demonstrated statistically significant decrease in spasticity at the end of first and third months (p<0.05). We saw a significant decrease in the spasticity of upper and lower extremities in patients with focal spasiticity who received BTX-A injections. We suggest that if BTX-A injections are supported with orthoses and exercise programs, then functional status of the patients would be better.