- Title
- Long-term effect of additional rehabilitation following botulinum toxin-A on upper limb activity in chronic stroke: the InTENSE randomised trial
- Creator
- Lannin, Natasha A.; Ada, Louise; Cameron, Ian D.; English, Coralie; Ratcliffe, Julie; Faux, Steven; Palit, Mithu; Gonzalez, Senen; Olver, John; Schneider, Emma; Crotty, Maria
- Relation
- BMC Neurology Vol. 22, no. 154
- Publisher Link
- http://dx.doi.org/10.1186/s12883-022-02672-8
- Publisher
- BioMed Central Ltd.
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: It is common for people with persistent spasticity due to a stroke to receive an injection of botulinum toxin-A in the upper limb, however post-injection intervention varies. Aim: To determine the long-term effect of additional upper limb rehabilitation following botulinum toxin-A in chronic stroke. Method: An analysis of long-term outcomes from national, multicenter, Phase III randomised trial with concealed allocation, blinded measurement and intention-to-treat analysis was carried out. Participants were 140 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 greater than 3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus 3 months of evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scale) and upper limb activity (Box and Block Test) at 12 months (ie, 9 months beyond the intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results: By 12 months, the experimental group scored the same as the control group on the Goal Attainment Scale (MD 0 T-score, 95% CI -5 to 5) and on the Box and Block Test (MD 0.01 blocks/s, 95% CI -0.01 to 0.03). There were no differences between groups on any secondary outcome. Conclusion: Additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not more effective in the long-term.
- Subject
- botulinum toxin type A; stroke; spasticity; wrist; rehabilitation; neuroscience
- Identifier
- http://hdl.handle.net/1959.13/1484714
- Identifier
- uon:51414
- Identifier
- ISSN:1471-2377
- Language
- eng
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