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Botulinum toxin type A (BtxA) injection and modified constraint-induced movement therapy (mCIMT) are both promising approaches to enhance recovery after stroke. However, the combined application of the two modalities has rarely been studied. The aim was to investigate whether combined BtxA and mCIMT would produce greater improvements in spasticity and upper extremity function than BtxA plus conventional rehabilitation in chronic stroke patients with upper extremity spasticity.
Botulinum toxin type A (BtxA) injection and modified constraint-induced movement therapy (mCIMT)are both promising approaches to enhance recovery after stroke. However, the combined application of the two modalities has rarely been studied. To date, only a single case report addressed this issue. Theoretically, application of a mCIMT program with intensive functional tasks practice after spasticity reduction by BtxA may improve affected upper extremity function in patients with poststroke spasticity. The aim was to investigate whether combined BtxA and mCIMT would produce greater improvements in spasticity and upper extremity function than BtxA plus conventional rehabilitation in chronic stroke patients with upper extremity spasticity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Experimental | BtxA+mCIMT (combination group) |
|
| 2 | Placebo Comparator | BtxA+ conventional rehabilitation (control group) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BtxA+mCIMT | Other | The combination group receive BtxA+mCIMT for 2 hours/day, 3 days/week for 3 months. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The primary outcome assessed spasticity on the Modified Ashworth Scale. | MAS evaluated before BtxA injection, at 4 weeks, 3 months and 6 months postinjection. |
| Measure | Description | Time Frame |
|---|---|---|
| Secondary outcomes assessed real-world arm function (Motor Activity Log), laboratory motor activity (Action Research Arm Test) and patients' global satisfaction. | evaluated before BtxA injection, at 4 weeks, 3 months and 6 months postinjection. |
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Inclusion Criteria:
Exclusion Criteria:
All patients were not currently participating in any experimental studies and did not receive concomitant oral anti-spastic medication during the study period
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| Name | Affiliation | Role |
|---|---|---|
| Shu-Fen Sun, MD | Department of Physical Medicine and Rehabilitation | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17012643 | Background | Sun SF, Hsu CW, Hwang CW, Hsu PT, Wang JL, Yang CL. Application of combined botulinum toxin type A and modified constraint-induced movement therapy for an individual with chronic upper-extremity spasticity after stroke. Phys Ther. 2006 Oct;86(10):1387-97. doi: 10.2522/ptj.20050262. |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D009128 | Muscle Spasticity |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| BtxA+ conventional rehabilitation | Other | The control group received for 2 hours/day, 3 days/week for 3 months. |
|
|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009122 | Muscle Hypertonia |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |