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post-stroke spasticity

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https://www.readbyqxmd.com/read/28289789/-medical-care-of-patients-with-spasticity-following-stroke-evaluation-of-the-treatment-situation-in-germany-with-focus-on-the-use-of-botulinum-toxin
#1
L Kerkemeyer, G Lux, A Walendzik, J Wasem, A Neumann
BACKGROUND: Upper limb spasticity is a common complication following stroke. Cohort studies found 19% of post-stroke patients had upper limb spasticity at 3 months and 38% of patients at 12 months. For focal spasticity, intramuscular injections of botulinum toxin are indicated. In Germany, it is assumed that patients with the described indication are undersupplied with botulinum toxin. OBJECTIVE: The aim of the present study is to evaluate the medical care of patients with upper limb spasticity post-stroke with the focus on the use of botulinum toxin as one treatment option...
March 13, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28286053/onabotulinumtoxina-for-lower-limb-spasticity-guidance-from-a-delphi-panel-approach
#2
Alberto Esquenazi, Abraham Alfaro, Ziyad Ayyoub, David Charles, Khashayar Dashtipour, Glenn D Graham, John R McGuire, Ib R Odderson, Atul T Patel, David M Simpson
BACKGROUND: OnabotulinumtoxinA is approved for the treatment of upper and lower limb spasticity in adults. Guidance on common postures and onabotulinumtoxinA injection paradigms for upper limb spasticity has been developed using a Delphi Panel. However, similar guidance for lower limb spasticity has not been established. OBJECTIVE: To define a clinically recommended treatment paradigm using onabotulinumtoxinA for each common posture among patients with post-stroke lower-limb spasticity (PSLLS); to identify the most common PSLLS aggregate postures...
March 7, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28285729/evaluation-of-post-stroke-spastic-muscle-stiffness-using-shear-wave-ultrasound-elastography
#3
Chueh-Hung Wu, Yu-Chun Ho, Ming-Yen Hsiao, Wen-Shiang Chen, Tyng-Guey Wang
Current clinical evaluations of post-stroke upper limb spasticity are subjective and qualitative. We proposed a quantitative measurement of post-stroke spastic muscle stiffness by using shear-wave ultrasound elastography and tested its reliability. Acoustic radiation force impulse with shear wave velocity (SWV) detection was used to evaluate stiffness of the biceps brachii muscles at 90° and 0° elbow flexion. In 21 control subjects, SWV did not significantly differ between dominant and non-dominant sides at either flexion angle (0°: p = 0...
March 9, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28275351/botulinum-toxin-is-effective-in-the-management-of-neurogenic-dysphagia-clinical-electrophysiological-findings-and-tips-on-safety-in-different-neurological-disorders
#4
Enrico Alfonsi, Domenico A Restivo, Giuseppe Cosentino, Roberto De Icco, Giulia Bertino, Antonio Schindler, Massimiliano Todisco, Mauro Fresia, Andrea Cortese, Paolo Prunetti, Matteo C Ramusino, Arrigo Moglia, Giorgio Sandrini, Cristina Tassorelli
Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28272726/-measurement-of-the-outcomes-in-acquired-brain-injury-in-a-neurorehabilitation-unit-a-long-term-study
#5
V Cruz-Guisado, P Diaz-Borrego, B Romero-Romero, M Rodriguez-Pinero Duran
INTRODUCTION: Following sudden brain damage, there is a loss of capabilities that affects the person's autonomy. Recovery from the physical, psychic and cognitive sequelae requires the application of multiple therapies, the outcomes of which need to be measured objectively. Our aim is to analyse the application of standardised instruments in determining the therapeutic outcomes in acquired brain injury. PATIENTS AND METHODS: We conducted a retrospective descriptive observational study lasting 13 months...
March 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28211822/robot-assisted-end-effector-based-gait-training-in-chronic-stroke-patients-a%C3%A2-multicentric-uncontrolled-observational-retrospective-clinical-study
#6
Stefano Mazzoleni, Antonella Focacci, Marco Franceschini, Andreas Waldner, Chiara Spagnuolo, Elena Battini, Donatella Bonaiuti
BACKGROUND: Until now studies report inconclusive results as regards the effectiveness of exclusive use of robot-assisted training and clinical indications in stroke patients. OBJECTIVE: To evaluate if the only robot-assisted end-effector-based gait training can be feasible in chronic stroke subjects in terms of gait recovery. METHODS: Five rehabilitation centers participated and one hundred chronic post-stroke patients were recruited. Patients underwent a robot-assisted end-effector-based gait training as only rehabilitation treatment...
February 15, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28145396/a-randomized-controlled-trial-on-the-immediate-and-long-term-effects-of-arm-slings-on-shoulder-subluxation-in-stroke-patients
#7
Anke VAN Bladel, Gert Lambrecht, Kristine M Oostra, Guy Vanderstraeten, Dirk Cambier
BACKGROUND: Arm slings are often used in clinical practice to support the hemiplegic arm aiming to prevent or treat glenohumeral subluxation. Evidence supporting the corrective effect of slings on subluxation is scarce and long-term studies are lacking. AIM: To determine both the immediate and long-term effect on acromiohumeral distance using the Actimove® sling (BSN medical SA-NV, Leuven, Belgium) and Shoulderlift (V!GO, Belgium) and to determine the effect of slings on pain and passive range of motion of the shoulder in stroke patients with glenohumeral subluxation...
January 30, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28131185/combined-therapy-using-botulinum-toxin-a-and-single-joint-hybrid-assistive-limb-for-upper-limb-disability-due-to-spastic-hemiplegia
#8
Kazuya Saita, Takashi Morishita, Koichi Hyakutake, Hiroyuki Fukuda, Etsuji Shiota, Yoshiyuki Sankai, Tooru Inoue
We investigated the combination of robot-assisted rehabilitation (RT) using a single-joint hybrid assistive limb (HAL-SJ) and botulinum toxin A (BTX-A) as therapy for paretic arm with spasticity in post-stroke patients. Participants were seven patients (4 females, 3 males; mean (±SD) age: 60.6±8.4years) who had spastic hemiplegia following chronic stroke. On the day following BTX-A injection, we started RT, which was performed for 20 sessions of 60min each over a two-week period. Clinical outcome measures, including Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Disability Assessment Scale (DAS), and cortical activity were evaluated at baseline, and two weeks, and four months following BTX-A injection...
February 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28118733/safety-and-efficacy-of-letibotulinumtoxina-botulax%C3%A2-in-treatment-of-post-stroke-upper-limb-spasticity-a-randomized-double-blind-multi-center-phase-iii-clinical-trial
#9
Kyung Hee Do, Min Ho Chun, Nam-Jong Paik, Yoon Ghil Park, Shi-Uk Lee, Min-Wook Kim, Don-Kyu Kim
OBJECTIVE: To investigate a new botulinum neurotoxin type A, termed letibotulinumtoxinA(Botulax(®)) and compare its efficacy and safety for post-stroke upper limb spasticity with that of onabotulinumtoxinA(Botox(®)). DESIGN: A prospective, double-blinded, multicenter, randomized controlled clinical study. SETTING: Six university hospitals in Korea. SUBJECTS: A total of 187 stroke participants with upper limb spasticity...
January 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28071962/the-feasibility-of-functional-electrical-stimulation-to-improve-upper-extremity-function-in-a-two-year-old-child-with-perinatal-stroke-a-case-report
#10
Kristin E Musselman, Patricia Manns, Jaclyn Dawe, Rhina Delgado, Jaynie F Yang
AIMS: To evaluate the effectiveness and feasibility (i.e. tolerability, adherence) of functional electrical stimulation (FES) for the upper extremity (UE) in a two-year-old child with perinatal stroke. METHODS: Forty hours of FES over eight weeks was prescribed. FES to the hemiplegic triceps, extensor carpi radialis longus and brevis, extensor carpi ulnaris and extensor digitorum was timed with reaching during play. Assessments were performed before, during, and two months post-intervention...
January 10, 2017: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/27940322/an-improved-approach-for-measuring-the-tonic-stretch-reflex-response-of-spastic-muscles
#11
Maristella Borges Silva, Andrei Nakagawa Silva, Eduardo Lázaro Martins Naves, Evanisi Teresa Palomari, Alcimar Barbosa Soares
We propose a new method for detecting the onset of the stretch reflex response for assessment of spasticity based on the Tonic Stretch Reflex Threshold (TSRT). Our strategy relies on a three-stage approach to detect the onset of the reflex EMG activity: (i) Reduction of baseline activity by means of Empirical Mode Decomposition; (ii) Extraction of the complex envelope of the EMG signal by means of Hilbert Transform (HT) and; iii) A double threshold decision rule. Simulated and real EMG data were used to evaluate and compare our method (TSRT-EHD) against three other popular methods described in the literature to assess TSRT ('Kim', 'Ferreira' and 'Blanchette')...
December 2, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27880052/functional-impact-of-different-muscle-localization-techniques-for-botulinum-neurotoxin-a-injections-in-clinical-routine-management-of-post-stroke-spasticity
#12
Kirsten E Zeuner, Arne Knutzen, Carina Kühl, Bettina Möller, Helge Hellriegel, Nils G Margraf, Günther Deuschl, Henning Stolze
BACKGROUND: Treatment options for spasticity include intramuscular botulinum neurotoxin A (BoNT-A) injections. Both ultrasound (US) or electromyographic (EMG) guided BoNT-A injections are employed to isolate muscles. To date, most studies have included patients naïve to BoNT-A or following a prolonged wash out phase. OBJECTIVE: To determine the impact of US/EMG guided BoNT-A injections on function in outpatients with spasticity receiving an established re-injection regime...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27879456/hindlimb-spasticity-after-unilateral-motor-cortex-lesion-in-rats-is-reduced-by-contralateral-nerve-root-transfer
#13
Haiyang Zong, Fenfen Ma, Laiyin Zhang, Huiping Lu, Jingru Gong, Min Cai, Haodong Lin, Yizhun Zhu, Chunlin Hou
Lower extremity spasticity is a common sequela among patients with acquired brain injury. The optimum treatment remains controversial. The aim of our study was to test the feasibility and effectiveness of contralateral nerve root transfer in reducing post stroke spasticity of the affected hindlimb muscles in rats. In our study, we for the first time created a novel animal hindlimb spastic hemiplegia model in rats with photothrombotic lesion of unilateral motor cortex and we established a novel surgical procedure in reducing motor cortex lesion-induced hindlimb spastic hemiplegia in rats...
December 2016: Bioscience Reports
https://www.readbyqxmd.com/read/27871449/botulinum-toxin-as-early-intervention-for-spasticity-after-stroke-or-non-progressive-brain-lesion-a-meta-analysis
#14
Raymond L Rosales, Fran Efendy, Ericka Sa Teleg, Mary Md Delos Santos, Mary Ce Rosales, Marc Ostrea, Michelle J Tanglao, Arlene R Ng
Spasticity is a functionally limiting disorder that commonly occurs following stroke or severe brain injury, and may lead to disability and pain. In tandem with neurorehabilitation, botulinum toxin type A (BoNT-A) is the recommended first-line treatment for spasticity and, to date, the majority of trials have reported BoNT-A use in patients >6months after ictus. The present meta-analysis aimed to evaluate the effects of early BoNT-A injection for post-stroke spasticity on improvements in hypertonicity, disability, function and associated pain...
December 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27834471/efficacy-and-safety-of-botulinum-toxin-type-a-for-upper-limb-spasticity-after-stroke-or-traumatic-brain-injury-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#15
Yan Dong, Tao Wu, Xiaohua Hu, Tong Wang
INTRODUCTION: Muscle spasticity is a positive symptom after stroke and traumatic brain injury. Botulinum Toxin type A injection is widely used for treating post stroke and traumatic brain injury spasticity. This study aimed to evaluate efficacy and safety of Botulinum Toxin type A for upper limb spasticity after stroke and traumatic brain injury and investigate reliability and conclusiveness of available evidence for Botulinum Toxin type A intervention. EVIDENCE ACQUISITION: We searched electronic databases from inception to September 10 of 2016...
November 11, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27824235/radial-shock-wave-therapy-effect-on-pain-and-motor-performance-in-a-paralympic-athlete-a-case-report
#16
Laura Mori, Lucio Marinelli, Elisa Pelosin, Matteo Gambaro, Roberto Trentini, Giovanni Abbruzzese, Carlo Trompetto
BACKGROUND: Recent studies demonstrated the usefulness of Radial Shock Waves Therapy (RSWT) in treating hypertonia in patients affected by cerebral palsy (CP), stroke, and dystonia. RSWT have never been used to treat spasticity in disabled athletes. CASE REPORT: An athlete affected by tetraparesis due to CP underwent three RSWT sessions in a week. We assessed muscular tone using the Modified Ashworth scale (MAS), pain and fatigue experienced during athletic performance with Visual Analogic Scale (VAS) and Borg scale Category-Ratio anchored at number 10 (Borg CR10)...
November 8, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27814307/effect-of-shock-wave-therapy-on-ankle-plantar-flexors-spasticity-in-stroke-patients
#17
Salah Sawan, Foad Abd-Allah, Montasser M Hegazy, Mohammad A Farrag, Nancy Hosney Sharf El-Den
BACKGROUND: Large number of patients with first-ever stroke developed spasticity. Spasticity can reduce the range of motion, hinder voluntary movements, provoke pain, and result in impairment of functional activities of daily living. OBJECTIVE: Demonstrate the effect of shock wave therapy on ankle plantar flexors spasticity in stroke patients. METHODS: We included forty ischemic stroke patients divided into 2 groups; group I were subjected to the selected physical therapy program and shock wave therapy whereas group II received the selected physical therapy program as well as placebo shock wave for six weeks...
2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/27699753/-early-pharmacologic-treatment-with-botulinum-toxin-a-in-post-stroke-spasticity-consensus-evidence-based-recommendations
#18
REVIEW
L Lopez de Munain, F J Juan-Garcia, E Duarte, R Martin-Mourelle, S Rodriguez, S Moraleda-Perez
Spasticity is a common complication that occurs in those patients that have suffered a stroke. To identify those patients at high risk of having post-stroke spasticity and to start treatment at early stages would probably benefit the patient. The key aspects in the early management of post-stroke spasticity were review and the clinical implications and strength of evidences were also considered. The document drafted by the study coordinators was subsequently reviewed and then a validated document was developed...
October 16, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27696580/goal-attainment-scaling-in-individuals-with-upper-limb-spasticity-post-stroke
#19
Parvin Eftekhar, George Mochizuki, Tilak Dutta, Denyse Richardson, Dina Brooks
Focusing on rehabilitation goals is an effective approach for improving function in individuals with spasticity after stroke. The objectives of this study were to examine and map goals of post-stroke individuals with spasticity using the Goal Attainment Scale (GAS) and International Classification of Functioning, Disability and Health (ICF), and to evaluate the impact of botulinum toxin A (BoNTA) on occupational performance based on the type of rehabilitation goals. Thirty-one patients were recruited from an outpatient spasticity management clinic...
December 2016: Occupational Therapy International
https://www.readbyqxmd.com/read/27679870/assessment-of-forearm-muscle-spasticity-with-sonoelastography-in-patients-with-stroke
#20
Evren Yaşar, Emre Adigüzel, Serdar Kesikburun, Itır Yenihayat, Bilge Yilmaz, Rıdvan Alaca, Arif K Tan
OBJECTIVE: The aim of the study was to investigate the feasibility of sonoelastography to show muscle stiffness in post-stroke spasticity, and the relationship between sonoelastography findings and clinical spasticity scores in the spastic forearm muscles. METHODS: This study was carried out in a university rehabilitation centre. 23 patients with stroke with forearm muscle spasticity (≥1+ using the Modified Ashworth scale score and ≥1 using the Tardieu scale) were included...
December 2016: British Journal of Radiology
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