- Title
- Effect of additional rehabilitation after totulinum toxin-A on upper limb activity in chronic stroke The InTENSE Trial
- Creator
- Lannin, Natasha A.; Ada, Louise; English, Coralie; Ratcliffe, Julie; Faux, Steven G.; Palit, Mithu; Gonzalez, Senen; Olver, John; Cameron, Ian; Crotty, Maria
- Relation
- NHMRC.1079542 http://purl.org/au-research/grants/nhmrc/1079542
- Relation
- Stroke Vol. 51, Issue 2, p. 556-562
- Publisher Link
- http://dx.doi.org/10.1161/STROKEAHA.119.027602
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2020
- Description
- Background and Purpose: The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods: We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results: In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions: Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: ACTRN12615000616572. (Stroke. 2020;51:556-562. DOI: 10.1161/STROKEAHA.119.027602.)
- Subject
- botulinum toxin type A; neuroscience; pain; quality of life; spasticity; wrist
- Identifier
- http://hdl.handle.net/1959.13/1459450
- Identifier
- uon:45683
- Identifier
- ISSN:0039-2499
- Rights
- This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
- Language
- eng
- Full Text
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