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post-stroke spasticity

Semra Aktürk, Raikan Büyükavcı, Yüksel Ersoy
OBJECTIVE: The aim of this study is to identify the effect on spasticity and walking of US-guided botulinum toxin type A (BoNT-A) injections administered to improve equinovarus walking pattern commonly observed in patients after stroke. MATERIAL AND METHOD: Twenty-three patients with post-stroke spastic equinovarus deformity were recruited. The US-guided BoNT-A injections were administered into the spastic muscles (including gastrocnemius; GK, soleus; S and tibialis posterior; TP) using a specific approach, and all of the patients were enrolled in rehabilitation programmes after the injections...
March 9, 2018: Toxicon: Official Journal of the International Society on Toxinology
Hyun-Mi Oh, Geun-Young Park, Young Min Choi, Hyung Jung Koo, Yongjun Jang, Sun Im
BACKGROUND: There are no guidelines on the ideal time to inject botulinum toxin (BT-A) for lower leg spasticity in stroke patients. An early injection may produce unwanted weakness, interfering with gait recovery. OBJECTIVE: To evaluate whether the outcomes after BT-A injection for plantarflexion spasticity can be different according to stroke chronicity. DESIGN: A secondary analysis study from a double- blinded, randomized trial with group reclassification according to stroke chronicity SETTING: Two rehabilitation centres...
March 3, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Davide Corbetta, Elisabetta Sarasso, Federica Agosta, Massimo Filippi, Roberto Gatti
Background: Treatment of central post-stroke pain (CPSP) after a thalamic-capsular stroke is generally based on pharmacological approach as it is low responsive to physiotherapy. In this case report, the use of mirror therapy (MT) for the reduction of CPSP in a subject after a stroke involving thalamus is presented. Case presentation: Five years after a right lenticular-capsular thalamic stroke, despite a good recovery of voluntary movement that guaranteed independence in daily life activities, a 50-year-old woman presented with mild weakness and spasticity, an important sensory loss and a burning pain in the left upper limb...
2018: Archives of Physiotherapy
Mireia Raluy-Callado, Andrew Cox, Sharon MacLachlan, Abdel M Bakheit, A Peter Moore, Jerome Dinet, Sylvie Gabriel
OBJECTIVE: Post-stroke spasticity (PSS) is a common complication following stroke. This study describes the differences in healthcare resource utilization between patients who do and do not develop PSS in the United Kingdom. METHODS: Adults registered in The Health Improvement Network database with a recorded stroke between 2007 and 2011 were included. PSS was identified through Read codes; machine learning was used to retrospectively identify unrecorded PSS events...
February 28, 2018: Current Medical Research and Opinion
Marco Franceschini, Michela Goffredo, Sanaz Pournajaf, Stefano Paravati, Maurizio Agosti, Francesco De Pisi, Daniele Galafate, Federico Posteraro
BACKGROUND: Upper limb recovery is one of the main goals of post-stroke rehabilitation due to its importance for autonomy in Activities of Daily Living (ADL). Although the efficacy of upper limb Robot-assisted Therapy (RT) is well established in literature, the impact of the initial status of the patient on the effects of RT is still understudied. This paper aims to identify whether demographic, clinical and motor characteristics of stroke patients may influence the ability to independently perform ADL after RT...
2018: PloS One
Moisés Schabarum Dall'Agnol, Fernanda Cechetti
Consider the leading cause of disability in adults, stroke leads to different consequences, like hemiparesis and loss of function in the upper limb which can impair the performance of activities during daily life. Different techniques have been used to soften this process, like Acupuncture and Kinesio Taping (KT). However, there is no consensus on their concomitant effect on neurological patients. This study aimed to analyze the effects of acupuncture associated with KT on the upper limb of patients with chronic hemiparesis after stroke...
January 4, 2018: Journal of Acupuncture and Meridian Studies
Raikan Buyukavci, Semra Akturk, Yüksel Ersoy
BACKGROUND: Ultrasound-guided botulinum toxin type A injection is an effective treatment for spasticity. Euro-musculus spasticity approach is a new method for administering injections to the correct point of the correct muscle. The clinical outcomes of this practical approach is not yet available in the literature. AIM: The purpose of this study was to evaluate the effects on spasticity and the functional outcomes of ultrasound guided botulinum toxin type A injections via the Euro-musculus spasticity approach to treat upper limb spasticity in post-stroke patients...
February 7, 2018: European Journal of Physical and Rehabilitation Medicine
G Shankar Ganesh, Ranjita Kumari, Monalisa Pattnaik, Patitapaban Mohanty, Chittaranjan Mishra, Parminder Kaur, Anandhi Dakshinamoorthy
BACKGROUND AND PURPOSE: Spasticity is a major disabling symptom in patients post stroke. Though studies have demonstrated that electrical stimulation (ES) can reduce spasticity and improve passive ankle range of motion (ROM), not many studies have evaluated the effectiveness of ES on active ankle ROM. The purpose of this study was to determine the effectiveness of Faradic and Russian currents in the reduction of ankle plantar-flexor spasticity and improving motor recovery in patients post stroke...
February 8, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Jing Gao, Wen He, Li-Juan Du, Johnson Chen, David Park, Michael Wells, Brian Fowlkes, Michael O'Dell
We prospectively investigated the feasibility of using quantitative ultrasound imaging (QUI) to assess the biceps brachii muscle (BBM) in individuals with chronic post-stroke spasticity. To quantify muscle echogenicity and stiffness, we measured QUI parameters (gray-scale pixel value and shear wave velocity [SWV, m/s]) of the BBM in three groups: 16 healthy BBMs; 12 post-stroke, non-spastic BBMs; and 12 post-stroke, spastic BBMs. The QUI results were compared with the Modified Ashworth Scale and Tardieu Scale...
February 2, 2018: Ultrasound in Medicine & Biology
Theodore Wein, Alberto Esquenazi, Wolfgang H Jost, Anthony B Ward, Grace Pan, Rozalina Dimitrova
BACKGROUND: Post-stroke distal lower limb spasticity impairs mobility, limiting activities of daily living, requiring additional caregiver time. OBJECTIVE: To evaluate the efficacy, safety, and sustained benefit of onabotulinumtoxinA in adults with post-stroke lower limb spasticity (PSLLS). DESIGN: A multicenter, randomized, double-blind, phase 3, placebo-controlled trial. SETTING: 60 study centers across North America, Europe, Russia the United Kingdom, and South Korea...
January 9, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Maria Pais de Carvalho, Daniela Pinto, Melissa Gorayeb, Jorge Jacinto
Background Botulinum toxin type-A (BoNTA) is a recognized treatment for upper limb spasticity (ULS) after stroke, but there aren't many studies analyzing its effect in shoulder muscles. Objective To evaluate the efficacy of BoNTA injections for ULS, when shoulder muscles are included. Methods A cross-sectional study. Data from clinical forms of outpatients, treated at a Rehabilitation Center (2001-2016). Analyzes: goals of treatment; demographic characteristics/goal; treatment success, using Goal Attainment Scaling...
January 11, 2018: Topics in Stroke Rehabilitation
Anupam Datta Gupta, Wing Hong Chu, Stuart Howell, Subhojit Chakraborty, Simon Koblar, Renuka Visvanathan, Ian Cameron, David Wilson
BACKGROUND: Improved walking is one of the highest priorities in people living with stroke. Post-stroke lower limb spasticity (PSLLS) impedes walking and quality of life (QOL). The understanding of the evidence of improved walking and QOL following botulinum toxin (BoNTA) injection is not clear. We performed a systematic review of the randomized control trials (RCT) to evaluate the effectiveness of BoNTA injection on walking and QOL in PSLLS. METHODS: We searched PubMed, Web of Science, Embase, CINAHL, ProQuest Thesis and Dissertation checks, Google Scholar, WHO International Clinical Trial Registry Platform, ClinicalTrials...
January 5, 2018: Systematic Reviews
Mindy F Levin, Melanie C Baniña, Silvi Frenkel-Toledo, Sigal Berman, Nachum Soroker, John M Solomon, Dario G Liebermann
BACKGROUND: Recovery of voluntary movement is a main rehabilitation goal. Efforts to identify effective upper limb (UL) interventions after stroke have been unsatisfactory. This study includes personalized impairment-based UL reaching training in virtual reality (VR) combined with non-invasive brain stimulation to enhance motor learning. The approach is guided by limiting reaching training to the angular zone in which active control is preserved ("active control zone") after identification of a "spasticity zone"...
January 4, 2018: Trials
Kosuke Watanabe, Yosuke Kudo, Eriko Sugawara, Tomoki Nakamizo, Kazumitsu Amari, Koji Takahashi, Osamu Tanaka, Miho Endo, Yuko Hayakawa, Ken Johkura
BACKGROUND AND PURPOSE: Repetitive transcranial magnetic stimulation (rTMS) is reported to improve chronic post-stoke hemiparesis. However, application of rTMS during the acute phase of post-stroke has not fully been investigated. We investigated the safety and the efficacy of intermittent theta-burst stimulation (iTBS) of the affected motor cortex and 1-Hz stimulation of the unaffected hemisphere during the acute phase in patients with hemiparesis due to capsular infarction. METHODS: Twenty one patients who met the study criteria were randomly assigned to receive, starting within 7days after stroke onset and for a period of 10days, iTBS of the affected motor cortex hand area (n=8), 1-Hz stimulation of the unaffected motor cortex hand area (n=7), or sham stimulation (n=6)...
January 15, 2018: Journal of the Neurological Sciences
Mariéle Marchezan Zarantonello, Marco Antonio Stefani, João Carlos Comel
[Purpose] The purpose is to analyze the effects of Constraint-induced Movement Therapy in post stroke patients in chronic course. [Subjects and Methods] This is a Quasi-experiment study and the adopted protocol consisted of a three-hour therapy for ten consecutive working days applied to a constraint intact upper limb. Surface Electromyography, Motor Activity Log, Wolf Motor Function Test and Functional Independence Measure were used for evaluating the experiment. [Results] The individuals showed reduction in the degree of spasticity, confirmed by Surface Electromyography...
November 2017: Journal of Physical Therapy Science
Derek M Miller, William Z Rymer
Aberrant vestibular nuclear function is proposed to be a principle driver of limb muscle spasticity after stroke. We sought to determine whether altered cortical modulation of descending vestibulospinal pathways post-stroke could impact the excitability of biceps brachii motoneurons. Twelve chronic hemispheric stroke survivors aged 46-68 years were enrolled. Sound evoked biceps myogenic potentials (SEBMPs) were recorded from the spastic and contralateral biceps muscles using surface EMG electrodes. We assessed the impact of descending vestibulospinal pathways on biceps muscle activity and evaluated the relationship between vestibular function and the severity of spasticity...
2017: Frontiers in Human Neuroscience
Wouter J Harmsen, Gerard M Ribbers, Majanka H Heijenbrok-Kal, Johannes B J Bussmann, Emiel M Sneekes, Ladbon Khajeh, Fop van Kooten, Sebastian J C M M Neggers, Rita J van den Berg-Emons
BACKGROUND: Aneurysmal subarachnoid hemorrhage (a-SAH) is a potential life-threatening stroke. Because survivors may be at increased risk for inactive and sedentary lifestyles, this study evaluates physical activity (PA) and sedentary behavior (SB) in the chronic phase after a-SAH. METHODS: PA and SB were objectively measured at six months post a-SAH with an accelerometer-based activity monitor, with the aim to cover three consecutive weekdays. Total time spent in PA (comprising walking, cycling, running and non-cyclic movement) and SB (comprising sitting and lying) was determined...
November 23, 2017: Journal of Neuroengineering and Rehabilitation
Alessandro Picelli, Alessio Baricich, Elena Chemello, Nicola Smania, Carlo Cisari, Marialuisa Gandolfi, Nicoletta Cinone, Maurizio Ranieri, Andrea Santamato
The tibialis posterior muscle is a frequent target for injection of botulinum toxin during the management of spastic equinovarus foot in adults with post-stroke spasticity. Although it is deep-seated, the needle insertion into the tibialis posterior muscle is usually performed using anatomical landmarks and safety information obtained from healthy subjects and cadavers. Our aim was to evaluate the botulinum toxin injection site for the medial approach to the tibialis posterior muscle in chronic stroke patients with spastic equinovarus foot...
November 18, 2017: Toxins
Jennilee K Carlyle, George Mochizuki
BACKGROUND: Individuals with spasticity after stroke experience a decrease in force steadiness which can impact function. Alterations in the strength of EMG-force coupling may contribute to the reduction in force steadiness observed in spasticity. The aim was to determine the extent to which force steadiness and EMG-force coupling is affected by post-stroke spasticity. METHODS: This cross-sectional study involved individuals with upper limb spasticity after stroke...
February 2018: Journal of Electromyography and Kinesiology
Lina M Chavez, Shiang-Suo Huang, Iona MacDonald, Jaung-Geng Lin, Yu-Chen Lee, Yi-Hung Chen
Acupuncture is recommended by the World Health Organization (WHO) as an alternative and complementary strategy for stroke treatment and for improving stroke care. Clinical trial and meta-analysis findings have demonstrated the efficacy of acupuncture in improving balance function, reducing spasticity, and increasing muscle strength and general well-being post-stroke. The mechanisms underlying the beneficial effects of acupuncture in stroke rehabilitation remain unclear. The aim of this study was to conduct a literature review, summarize the current known mechanisms in ischemic stroke rehabilitation through acupuncture and electroacupuncture (EA) therapy, and to detail the frequently used acupoints implicated in these effects...
October 28, 2017: International Journal of Molecular Sciences
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