The Evaluation of Botulinum Toxin Injection Effect for Poststroke Spasticity Treatment

Abstract

Objective: In this study we aimed to evaluate the effectivity of treatment with the botulinum toxin-type A (BTX-A) on spasticity, spasticity-related pain, and the daily living activities in post-stroke patients with upper or lower limb spasticity.

Materials and Methods: A total of 35 (23 right side, 12 left side) post-stroke patients who had upper and/or lower limb spasticity were enrolled to the study. BTX-A (249±41 U) was applied to their affected extremities. The degree of spasticity in the upper (elbow, wrists, and fingers) and lower (leg, knee and ankle) extremities was evaluated before treatment, 1 month, and 3 months after treatment using Modified Ashworth Scale (MAS). Daily life activities and severity of spasticity-related pain were also evaluated using the Barthel index and Visual Analogue Scale (VAS) at the same time points.

Results: The average age of the patients in the study was 60±6 years. Both upper and lower extremities were affected in 69%, whereas upper or lower extremities were affected in 31% of patients. BTX-A provided improvement in severity of the spasticity, pain scale, functionality, and quality of life according to the MAS, VAS, and Barthel indexes.The benefits were sustained in the first 3 months of the post-treatment.

Conclusion: BTX-A in the treatment of post-stroke spasticity is a reliable method in terms of adverse effects, pain reduction, its ability to provide long-term effectiveness, and increase functionality and quality of life.