A single group, pretest-posttest clinical trial for the effects of botulinum toxin injection using dual guidance into the upper extremity muscles for the treatment of focal spasticity in patients with chronic stroke

Abstract

Objective: This study aimed to determine if ultrasonography and electrical muscle stimulation-guided botulinum toxin injection into the upper extremity muscles increases the efficacy of the treatment of focal spasticity in patients with chronic stroke.Materials and Methods: This study included 22 chronic hemiplegic stroke patients with grade 2 and 3 spasticity in the upper extremity muscles, based on the Modified Ashworth Scale. The study hypothesis was that ultrasonography and electrical muscle stimulation-guided botulinum toxin injection would increase the efficacy of the treatment of spasticity. The Modified Ashworth Scale, Tardieu Scale, Barthel Index and Fugl-Meyer Motor Assessment Scale were administered at baseline, and at 2 weeks and 2 months post treatment.Results: All parameters were improved significantly at 2 weeks post treatment, as compared to baseline, and the observed improvement persisted at 2 months post treatment (P < 0.05). Conclusion: Ultrasonography and electrical muscle stimulation-guided botulinum toxin injection significantly improved spasticity and functional recovery in chronic stroke patients with upper extremity spasticity.