1. Yersal O. Clinical outcome of patients with glioblastoma multiforme: 1. Hankey GJ, Stroke. How large a public health problem and how can the neurologist help? Arch Neurol. 1999;56(6):748-54.
2. Ozcakir S, Sivrioglu K. Botulinum Toxin in Poststroke Spasticity, Clin Med Res. 2007;5(2):132-8.
4. Karataş GK. Bölüm 168, İnme, Fiziksel Tıp ve Rehabilitasyon, 2. Baskı. (Ed: Beyazova M, Kutsal YG), Güneş Tıp Kitabevleri. 2011; 2761-88.
5. Simpson D.M. Clinical trials of botulinum toxin in the treatment of spasticity: Etiology, Evaluation, Management and the Role of Botulinum Toxin, chapter 10. 2002; 125-30.
6. Çeliker R. Bölüm 58, Spastisite Tedavisinde Kullanılan İlaçlar, Fiziksel Tıp ve Rehabilitasyon, 2. Baskı, (Ed: Beyazova M, Kutsal YG), Güneş Tıp Kitabevleri. 2011; 901-17.
7. Picelli A, Lobba D, Midiri A, Prandi P, Melotti C, Baldessarelli S,et al. Botulinum toxin injection into the forearm muscles for wrist and fingers spastic overactivity in adults with chronic stroke: a randomized controlled trial comparing three inject. Clin Rehabil. 2014;28(3):232-42.
8. Chin TY, Nattrass GR, Selber P, Graham HK. Accuracy of intramuscular injection of botulinum toxin A in juvenile cerebral palsy: a comparison between manual needle placement and placement guided by electrical stimulation. J Pediatr Orthop. 2005;25(3):286-91.
9. Kwon JY, Hwang JH, Kim JS. Botulinum toxin a injection into calf muscles for treatment of spastic equinus in cerebral palsy: a controlled trial comparing sonography and electric stimulation-guided injection techniques: a preliminary report. Am J Phys Med Rehabil. 2010;89(4):279-86.
10. Yang EJ, Rha DW, Yoo JK, Park ES. Accuracy of manual needle placement for gastrocnemius muscle in children with cerebral palsy checked against ultrasonography. Arch Phys Med Rehabil.2009 May;90(5):741-4.
11. G. Sheean, N. A. Lanninb, L. Turner-Stokes, B. Rawickid and B. J. Snowe. Botulinum toxin assessment, intervention and after-care for upper limb hypertonicity in adults: international consensus statement, European Journal of Neurology. 2010; (Suppl., 17).
12. Picelli A, Tamburin S, Bonetti P, Fontana C, Barausse M, Dambruoso F, Gajofatto F, Santilli V, Smania N. Botulinum toxin type A injection into the gastrocnemius muscle for spastic equinus in adults with stroke: a randomized controlled trial comparing. Am J Phys Med Rehabil. 2012;91(11):957-64.
13. Wissel J, Ward AB, Erztgaard P, Bensmail D, Hecht MJ, Lejeune TM,et al. European consensus table on the use of botulinum toxin type A in adult spasticity. J Rehabil Med. 2009;41(1):13-25.
14. Lapatki BG, van Dijk JP, van de Warrenburg BP, Zwarts MJ. Botulinum toxin has an increased effect when targeted toward the muscle’s endplate zone: A high-density surface EMG guided study. Clin Neurophysiol. 2011;122:1611-16.
15. Van Campenhout A, Molenaers G. Localization of the motor endplate zone in human skeletal muscles of the lower limb: Anatomical guidelines for injection with botulinum toxin. Dev Med Child Neurol. 2011;53:108-19.
An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance
Year 2018,
Volume: 5 Issue: 9, 326 - 330, 30.09.2018
Objective: This
study has aimed to compare the efficacy of botulinum toxin (BTX) injections,
applied to the upper limb muscles of the stroke patients in our clinic who
have being diagnosed with focal spasticity, that are performed via
ultrasonography and ultrasonography + electrical muscle (EM) stimulator
guidance. Literature didn’t include detailed crosscheck of ultrasound guided
BTX and EM treatment applications for upper limb focal spasticity patients
Materials and Methods:
Electronic data on 62 hemiplegic stroke patients with grade 2 and 3 focal
spasticity who had received botulinum toxin injections into their upper limb
muscles by the same physician, who used similar protocol and recorded the
results, were scanned retrospectively. The spasticity of the patients in both
groups was assessed with the Modified Ashworth Scale at the end of two weeks
and three months.
Results: A
statistically significant difference was found between the Modified Ashworth
Scale values of both groups in terms of all muscles, compared to the values
seen in the pre-treatment period (p<0.05). The Modified Ashworth Scale
values at 3 months posttreatment in ultrasonography + electrical muscle
stimulator group were not statistically different from those at 2 weeks
posttreatment, with respect to wrist flexion and finger flexion. In
intergroup comparison, there was no statistically significant difference
between the Modified Ashworth Scale values of at pretreatment and 2 weeks
posttreatment. However, statistically significant difference in all muscle
groups was found in favor of the ultrasonography + electrical muscle
stimulator group at 3 months posttreatment controls (p<0.05).
Conclusion: Upper
limb spasticity due to stroke can be substantially recovered with botulinum
toxin injections that are applied via only ultrasonography guidance or via
ultrasonography + electrical muscle stimulator guidance.. According to data
from the assessment at 3 months posttreatment, the botulinum toxin injection
performed via ultrasonography + electrical muscle stimulator guidance had
more positive effects .
1. Yersal O. Clinical outcome of patients with glioblastoma multiforme: 1. Hankey GJ, Stroke. How large a public health problem and how can the neurologist help? Arch Neurol. 1999;56(6):748-54.
2. Ozcakir S, Sivrioglu K. Botulinum Toxin in Poststroke Spasticity, Clin Med Res. 2007;5(2):132-8.
4. Karataş GK. Bölüm 168, İnme, Fiziksel Tıp ve Rehabilitasyon, 2. Baskı. (Ed: Beyazova M, Kutsal YG), Güneş Tıp Kitabevleri. 2011; 2761-88.
5. Simpson D.M. Clinical trials of botulinum toxin in the treatment of spasticity: Etiology, Evaluation, Management and the Role of Botulinum Toxin, chapter 10. 2002; 125-30.
6. Çeliker R. Bölüm 58, Spastisite Tedavisinde Kullanılan İlaçlar, Fiziksel Tıp ve Rehabilitasyon, 2. Baskı, (Ed: Beyazova M, Kutsal YG), Güneş Tıp Kitabevleri. 2011; 901-17.
7. Picelli A, Lobba D, Midiri A, Prandi P, Melotti C, Baldessarelli S,et al. Botulinum toxin injection into the forearm muscles for wrist and fingers spastic overactivity in adults with chronic stroke: a randomized controlled trial comparing three inject. Clin Rehabil. 2014;28(3):232-42.
8. Chin TY, Nattrass GR, Selber P, Graham HK. Accuracy of intramuscular injection of botulinum toxin A in juvenile cerebral palsy: a comparison between manual needle placement and placement guided by electrical stimulation. J Pediatr Orthop. 2005;25(3):286-91.
9. Kwon JY, Hwang JH, Kim JS. Botulinum toxin a injection into calf muscles for treatment of spastic equinus in cerebral palsy: a controlled trial comparing sonography and electric stimulation-guided injection techniques: a preliminary report. Am J Phys Med Rehabil. 2010;89(4):279-86.
10. Yang EJ, Rha DW, Yoo JK, Park ES. Accuracy of manual needle placement for gastrocnemius muscle in children with cerebral palsy checked against ultrasonography. Arch Phys Med Rehabil.2009 May;90(5):741-4.
11. G. Sheean, N. A. Lanninb, L. Turner-Stokes, B. Rawickid and B. J. Snowe. Botulinum toxin assessment, intervention and after-care for upper limb hypertonicity in adults: international consensus statement, European Journal of Neurology. 2010; (Suppl., 17).
12. Picelli A, Tamburin S, Bonetti P, Fontana C, Barausse M, Dambruoso F, Gajofatto F, Santilli V, Smania N. Botulinum toxin type A injection into the gastrocnemius muscle for spastic equinus in adults with stroke: a randomized controlled trial comparing. Am J Phys Med Rehabil. 2012;91(11):957-64.
13. Wissel J, Ward AB, Erztgaard P, Bensmail D, Hecht MJ, Lejeune TM,et al. European consensus table on the use of botulinum toxin type A in adult spasticity. J Rehabil Med. 2009;41(1):13-25.
14. Lapatki BG, van Dijk JP, van de Warrenburg BP, Zwarts MJ. Botulinum toxin has an increased effect when targeted toward the muscle’s endplate zone: A high-density surface EMG guided study. Clin Neurophysiol. 2011;122:1611-16.
15. Van Campenhout A, Molenaers G. Localization of the motor endplate zone in human skeletal muscles of the lower limb: Anatomical guidelines for injection with botulinum toxin. Dev Med Child Neurol. 2011;53:108-19.
Murat Kosem
This is me
University of Health Sciences, Sultan Abdulhamid Han Research Hospital, Department of Physical Medicine and Rehabilitation, IstanbulTürkiye
Ata, E., & Kosem, M. (2018). An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance. Medical Science and Discovery, 5(9), 326-330. https://doi.org/10.17546/msd.460182
AMA
Ata E, Kosem M. An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance. Med Sci Discov. September 2018;5(9):326-330. doi:10.17546/msd.460182
Chicago
Ata, Emre, and Murat Kosem. “An Effective Approach for Botulinum Toxin Injection in Patients With Stroke for Focal Spasticity: Dual Guidance”. Medical Science and Discovery 5, no. 9 (September 2018): 326-30. https://doi.org/10.17546/msd.460182.
EndNote
Ata E, Kosem M (September 1, 2018) An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance. Medical Science and Discovery 5 9 326–330.
IEEE
E. Ata and M. Kosem, “An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance”, Med Sci Discov, vol. 5, no. 9, pp. 326–330, 2018, doi: 10.17546/msd.460182.
ISNAD
Ata, Emre - Kosem, Murat. “An Effective Approach for Botulinum Toxin Injection in Patients With Stroke for Focal Spasticity: Dual Guidance”. Medical Science and Discovery 5/9 (September 2018), 326-330. https://doi.org/10.17546/msd.460182.
JAMA
Ata E, Kosem M. An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance. Med Sci Discov. 2018;5:326–330.
MLA
Ata, Emre and Murat Kosem. “An Effective Approach for Botulinum Toxin Injection in Patients With Stroke for Focal Spasticity: Dual Guidance”. Medical Science and Discovery, vol. 5, no. 9, 2018, pp. 326-30, doi:10.17546/msd.460182.
Vancouver
Ata E, Kosem M. An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance. Med Sci Discov. 2018;5(9):326-30.