Comparison of injectable botulinum toxin type A on muscle spasm and motor function in patients with subacute and convalescent stroke

JIA Cun-wei; XIE Zheng; ZHAO Bo

doi:10.3969/j.issn.1009-6574.2017.03.010

Abstract：Objective To evaluate the efficacy of injectable botulinum toxin type A on muscle spasms and motor function in subacute and convalescent stroke patients.Methods From June 2013 to Jan-uary 2016, 86 stroke patients were included in this study. They were divided into subacute group (<1 month, n=37) and convalescent group (≥1 month,n=49) according to the length of disease history. Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), Manual Muscle Test (MMT), Passive Range of Motion (PROM), Barthel index and Fugl-Meyer scale were evaluated after intramuscular injection of 200 U botulinum toxin for 4 weeks.Results All patients were successfully treated. The follow-up time was 26 d (22 ~ 30 d) and 29 d (24 ~ 31 d) separately, with no significant differences (Z=1.332,P=0.307). The MAS scores of subacute group in el-bow and wrist were improved after treatment (P<0.05), but there was no significant difference in convalescent group (P>0.05). Subacute group was significantly superior to convalescent group (P<0.05). The elbow R1, D and wrist R1 after treatment in subacute group were improved (P<0.05). Elbow R1, D and wrists R1 of MTS in convalescent group were improved after treatment (P<0.05). Wrist R1, R2 of subacute group were significantly superior to convalescent group (P<0.05). In the subacute group, the PROM abduction and activity of the wrist were improved (P<0.05). There was no significant improvement in convalescent group after treatment. The re-covery of the wrist in subacute group was better than that in convalescent group (P<0.05) . The Barthel index, Fugl-Meyer in subacute group and Fugl-Meyer of convalescent group were higher after treatment. But there was no significant difference between two groups (P>0.05).Conclusions Botulinum toxin can ameliorate the spas-ticity and function in patients with subacute and convalescent stage of stroke, but the effect for subacute stage is more obvious.