Application of combined botulinum toxin type A and modified constraint induced movement therapy for an individual with chronic upper-extremity spasticity after stroke

被引:21
作者
Sun, Shu-Fen
Hsu, Chien-Wei
Hwang, Chiao-Wen
Hsu, Pei-Te
Wang, Jue-Long
Yang, Chia-Lin
机构
[1] Vet Gen Hosp, Dept Phys Med & Rehabil, Kaohsiung 813, Taiwan
[2] Vet Gen Hosp, Dept Internal Med, Kaohsiung, Taiwan
来源
PHYSICAL THERAPY | 2006年 / 86卷 / 10期
关键词
botulinum toxin; constraint-induced movement therapy; spasticity; stroke;
D O I
10.2522/ptj.20050262
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background and Purpose. Constraint-induced movement therapy (CIMT) is a promising intervention for retraining upper-extremity function after a stroke. The purpose of this case report is to describe the use of a combination of botulinum toxin type A (BtxA) and a modified CIMT program for a patient with severe spasticity who was unable to use his right upper extremity. Case Description. The 52-year-old patient, who had a stroke 4 years ago, did not meet the minimum motor criteria for CIMT benefit. After receiving BtxA injections targeting the elbow, wrist, and finger flexors, he completed a 4-week program of modified CIMT followed by a 5-month home exercise program.. Outcomes. The patient exhibited improvement in muscle tone (the velocity-dependent resistance to stretch that muscle exhibits) and in scores on several upper-extremity function tests (Modified Ashworth Scale, Motor Activity Log, Wolf Motor Function Test, Action Research Arm Test, and Fugl-Meyer Assessment of Motor Recovery). He also reported making much progress in the functional use of the involved upper extremity. Discussion. In a patient with severe flexor spasticity and nonuse of the dominant upper extremity after a stroke, a combined treatment of BtxA and modified CIMT may have resulted in improved upper-extremity use.
引用
收藏
页码:1387 / 1397
页数:11
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