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The patients between the ages of 35-80 who developed spasticity in the upper extremity after stroke will be included.. Botulinum toxin(BT-A) injection will be applied to the study group(n=16) and placebo injection to the control group(n=15) in addition to conventional rehabilitation and stretching exercises. Evaluations will be made before the treatment, in the 2nd week, and in 3rd month after the treatment. Pain relief will be evaluated with the Visual Analog Scale(VAS) and spasticity assessment will be done with the Modified Ashworth Scale(MAS). The functionality will be evaluated with Fugl Meyer Assessment Scale(FMAS) and Box Block Test(BBT).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Group | Active Comparator | This is the group that will be injected with botulinum toxin for spasticity and stretching exercises will be given. |
|
| Control Group | Placebo Comparator | This is the group that will be injected with %0,9 NaCl for spasticity and stretching exercises will be given. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Botulinum toxin type A | Drug | Toxin of Clostridium Botulinum |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Pain - Visual Analog Scale | The shoulder pain of the patients will be evaluated during passive movement of the shoulder joint. The Visual Analogue Scale (VAS), a score between 0 and 10, will be used in the evaluation. | 2 weeks after treatment |
| Range of Motion | Passive flexion, abduction and external rotation of the shoulder, supination of the elbow, and extension of the wrist will be evaluated by the same physician by goniometry. In addition, elbow, proximal interphalangeal, and distal interphalangeal joints will be evaluated as a limitation of extension. | 2 weeks after treatment |
| Modified Ashworth Scale | The modified Ashworth Scale (MAS) will be used to evaluate spasticity. The adductor, internal rotator of shoulder, flexor of elbow, wrist and finger, pronator of elbow spasticities will be evaluated using MAS while the patient was in the sitting position. | 2 weeks after treatment |
| The Fugl-Meyer assessment scale | The Fugl-Meyer assessment scale (FMAS) will be used to evaluate the motor functions of the upper extremity. | 2 weeks after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Pain - Visual Analog Scale | The shoulder pain of the patients will be evaluated during passive movement of the shoulder joint. The Visual Analogue Scale (VAS), a score between 0 and 10, will be used in the evaluation. | 3 months after treatment |
| Range of Motion |
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Inclusion Criteria:
Exclusion Criteria:
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| %0,9 NaCl |
| Drug |
%0,9 NaCl |
|
Passive flexion, abduction and external rotation of the shoulder, supination of the elbow, and extension of the wrist will be evaluated by the same physician by goniometry. In addition, elbow, proximal interphalangeal, and distal interphalangeal joints will be evaluated as a limitation of extension. |
| 3 months after treatment |
| Modified Ashworth Scale | The modified Ashworth Scale (MAS) will be used to evaluate spasticity. The adductor, internal rotator of shoulder, flexor of elbow, wrist and finger, pronator of elbow spasticities will be evaluated using MAS while the patient was in the sitting position. | 3 months after treatment |
| The Fugl-Meyer assessment scale | The Fugl-Meyer assessment scale (FMAS) will be used to evaluate the motor functions of the upper extremity. | 3 months after treatment |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D009128 | Muscle Spasticity |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| 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 |
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| ID | Term |
|---|---|
| D019274 | Botulinum Toxins, Type A |
| ID | Term |
|---|---|
| D001905 | Botulinum Toxins |
| D008666 | Metalloendopeptidases |
| D010450 | Endopeptidases |
| D010447 | Peptide Hydrolases |
| D006867 | Hydrolases |
| D004798 | Enzymes |
| D045762 | Enzymes and Coenzymes |
| D045726 | Metalloproteases |
| D001426 | Bacterial Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D001427 | Bacterial Toxins |
| D014118 | Toxins, Biological |
| D001685 | Biological Factors |
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