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Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity
Author(s) -
See Michael KaWing,
Taw Benedict BengTeck,
Chan Edward ManTai,
Chan Linda YukYing,
Lo ShukMan,
Kwong Terrence WingCheung,
Leung Gilberto KaKit,
Lui WaiMan
Publication year - 2016
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12169
Subject(s) - spasticity , medicine , rehabilitation , physical medicine and rehabilitation , ankle , physical therapy , botulinum toxin , activities of daily living , modified ashworth scale , surgery
Aim Spasticity gives rise to impairment in motor functions and activities of daily living. Botulinum toxin ( BTX ) can be injected to temporarily paralyze the affected muscles, which provides a window of opportunity for rehabilitation. We present our 2.5‐year experience with BTX injection and a patient‐specific rehabilitation program provided by a multidisciplinary team, which consists of neurosurgeons, nurses, physiotherapists, occupational therapists and prosthetic orthotists. Patients and Methods This is a retrospective study of prospectively collected data in a local hospital including 22 patients suffering from spasticity. Outcome measures include goal attainment, caregiver burden and biomechanical assessment by M odified A shworth S cale and M odified T ardieu S cale ( MTS ). Results Onabotulinumtoxin A injection together with rehabilitation facilitates the attainment of patient‐centred physical goals in daily activities. It reduces caregiver burden. Spasticity is reduced particularly for finger and wrist flexors as well as hip adductors. Responses of ankle plantarflexors are less satisfactory which may be due to inadequate dosages. Initial improvement in the R2 component of the MTS for ankle plantarflexors and hip adductors may be attributable to the application of ankle–foot orthosis and abduction pillow. Conclusions Multidisciplinary management for spasticity is feasible within our healthcare setting and our promising findings indicate its wider adoption in this locality.