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Egyptian Rheumatology and Rehabilitation
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Objective assessment of cortical activity changes in stroke patients before and after hand rehabilitation with and without botulinum toxin injection

Egyptian Rheumatology and Rehabilitation volume 44, pages 172–180 (2017)Cite this article

Abstract

Background

Upper limb spasticity is a disabling condition and may result in severe functional limitation. The peripheral action of botulinum toxin (BTX) injection on spasticity is well known, but there are debates around its possible central action.

Aim

The aim of this study was to assess the clinical, functional, and cortical activation outcome of two antispastic treatments for stroke of the hand and wrist. Thirty patients with upper limb poststroke spasticity were recruited in this study.

Patients and methods

They were randomly allocated to two groups: group A and group B. Both groups received rehabilitation program, whereas group B received additional BTX injection. All patients were assessed at baseline and 8 weeks after treatment using the Modified Ashworth Scale, the Action Research Arm Test and Nine-Hole Peg Test, and somatosensory-evoked potential study of the median nerve.

Results

Group B showed a higher percentage of change in Modified Ashworth Scale of the wrist flexors and long flexors of fingers and in Action Research Arm Test compared with group A.

Conclusion

BTX injection in spastic muscles of the wrist and hand, followed by a rehabilitation program led to greater clinical and functional improvement compared with implementing the rehabilitation program alone.

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Authors and Affiliations

  1. Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Abassia, Cairo, Egypt

    Omnia A. Abu-Bakr MSc, Nagwaa M. M. Nassar, Amal M. Al-Ganzoury & Eman A. Tawfik

  2. Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Khaled Abo-Elfotouh Ahmed

Authors
  1. Omnia A. Abu-Bakr MSc
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  2. Nagwaa M. M. Nassar
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  3. Amal M. Al-Ganzoury
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  4. Khaled Abo-Elfotouh Ahmed
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  5. Eman A. Tawfik
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Correspondence to Omnia A. Abu-Bakr MSc.

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Abu-Bakr, O.A., Nassar, N.M.M., Al-Ganzoury, A.M. et al. Objective assessment of cortical activity changes in stroke patients before and after hand rehabilitation with and without botulinum toxin injection. Egypt Rheumatol Rehabil 44, 172–180 (2017). https://doi.org/10.4103/err.err_38_16

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  • DOI: https://doi.org/10.4103/err.err_38_16

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