Andrea Santamato1, Maria Francesca Micello2, Francesco Panza3, Francesca Fortunato4, Alessio Baricich5, Carlo Cisari5, Alberto Pilotto6, Giancarlo Logroscino7, Pietro Fiore8, Maurizio Ranieri2. 1. Physical Medicine and Rehabilitation Section, "OORR" Hospital, University of Foggia, Foggia, Italy. Electronic address: andrea.santamato@unifg.it. 2. Physical Medicine and Rehabilitation Section, "OORR" Hospital, University of Foggia, Foggia, Italy. 3. Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology of the University of Bari Aldo Moro, "Pia Fondazione Card G. Panico", Tricase, Lecce, Italy; Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy. Electronic address: geriat.dot@geriatria.uniba.it. 4. Sector of Hygiene, Department of Medical and Surgical Sciences, University of Foggia, Italy. 5. Physical Medicine and Rehabilitation, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy. 6. Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy; Geriatrics Unit, Azienda ULSS 16 Padova, S. Antonio Hospital, Padova, Italy. 7. Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology of the University of Bari Aldo Moro, "Pia Fondazione Card G. Panico", Tricase, Lecce, Italy. 8. Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
Abstract
BACKGROUND:Botulinum toxin type A is a first-line treatment for post-stroke focal spasticity, and the accuracy in delivering the toxin to the target muscles may influence the treatment outcome. Our aim was to compare the reduction of spasticity and the related finger position at rest improvement in post-stroke patients treated withbotulinum toxin type A in upper limb muscles using ultrasound guidance and manual needle placement. METHODS: In a randomized clinical trial, two groups of 15 stroke patients were treated with botulinum toxin type A injections in the wrist and finger flexor muscles of the affected upper limb using ultrasound guidance or manual needle placement. The Modified Ashworth Scale and the finger position at rest were measured at baseline and one month after toxin injections. RESULTS: After one month of follow-up from toxin injections, the Modified Ashworth Scale and finger position at rest significantly improved in both treatment groups, although these clinical outcomes were significantly better in patients treated under ultrasound guidance than in patients injected using manual needle placement. CONCLUSION: Ultrasound guidance for botulinum toxin type A injections could improve clinical outcome measures better than manual needle placement in post-stroke patients with spasticity.
RCT Entities:
BACKGROUND: Botulinum toxin type A is a first-line treatment for post-stroke focal spasticity, and the accuracy in delivering the toxin to the target muscles may influence the treatment outcome. Our aim was to compare the reduction of spasticity and the related finger position at rest improvement in post-strokepatients treated with botulinum toxin type A in upper limb muscles using ultrasound guidance and manual needle placement. METHODS: In a randomized clinical trial, two groups of 15 strokepatients were treated with botulinum toxin type A injections in the wrist and finger flexor muscles of the affected upper limb using ultrasound guidance or manual needle placement. The Modified Ashworth Scale and the finger position at rest were measured at baseline and one month after toxin injections. RESULTS: After one month of follow-up from toxin injections, the Modified Ashworth Scale and finger position at rest significantly improved in both treatment groups, although these clinical outcomes were significantly better in patients treated under ultrasound guidance than in patients injected using manual needle placement. CONCLUSION: Ultrasound guidance for botulinum toxin type A injections could improve clinical outcome measures better than manual needle placement in post-strokepatients with spasticity.
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