TY - JOUR
T1 - The Lack of Effect of Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke
T2 - A Short Report from the InTENSE Trial
AU - Cameron, Ian D
AU - Ada, Louise
AU - Crotty, Maria
AU - Palit, Mithu
AU - Huang, Lydia
AU - Olver, John
AU - Faux, Steven G
AU - Gonzales, Senen
AU - Anthonisz, Brian
AU - Bowman, Malcolm
AU - Watanabe, Yuriko
AU - Chow, Yan
AU - Milte, Rachel
AU - Ratcliffe, Julie
AU - English, Coralie K
AU - Lannin, Natasha A
PY - 2024/12
Y1 - 2024/12
N2 - We examined the effect of botulinum toxin-A on upper limb impairments and activity limitations in chronic stroke. This study is a secondary analysis of control group data from a national, multicenter, Phase III randomized trial with a masked outcome assessment. We studied 71 stroke survivors who received a botulinum toxin-A injection in any muscle(s) that crosses the wrist due to significant spasticity after a stroke greater than 3 months previously. We measured upper limb activity, spasticity, range of motion, grip strength, pain and other outcomes at injection and three months later. The median difference between injection and 3 months later was 0.0 blocks/s (interquartile range (IQR) 0.0) on the Box and Block Test, 0/4 (IQR 1) on the Tardieu Scale, 4 degrees (IQR 26) of wrist extension, 0.0 kg (IQR 2) of grip strength, 0.0 (IQR 1.5) on the 10 cm visual analogue scale for pain, 0/100 (IQR 21) on the 10 cm visual analogue scale for overall health, 0/3 (IQR 0) for self-care and −2 (IQR 8) for burden of care. In chronic stroke survivors who have little activity in their upper limb, botulinum toxin-A is not effective in improving any measured outcomes and does not appear to be clinically justified in this population with severe activity limitations.
AB - We examined the effect of botulinum toxin-A on upper limb impairments and activity limitations in chronic stroke. This study is a secondary analysis of control group data from a national, multicenter, Phase III randomized trial with a masked outcome assessment. We studied 71 stroke survivors who received a botulinum toxin-A injection in any muscle(s) that crosses the wrist due to significant spasticity after a stroke greater than 3 months previously. We measured upper limb activity, spasticity, range of motion, grip strength, pain and other outcomes at injection and three months later. The median difference between injection and 3 months later was 0.0 blocks/s (interquartile range (IQR) 0.0) on the Box and Block Test, 0/4 (IQR 1) on the Tardieu Scale, 4 degrees (IQR 26) of wrist extension, 0.0 kg (IQR 2) of grip strength, 0.0 (IQR 1.5) on the 10 cm visual analogue scale for pain, 0/100 (IQR 21) on the 10 cm visual analogue scale for overall health, 0/3 (IQR 0) for self-care and −2 (IQR 8) for burden of care. In chronic stroke survivors who have little activity in their upper limb, botulinum toxin-A is not effective in improving any measured outcomes and does not appear to be clinically justified in this population with severe activity limitations.
KW - botulinum toxin type-A
KW - movement pain
KW - quality of life
KW - rehabilitation
KW - spasticity
KW - wrist
UR - http://www.scopus.com/inward/record.url?scp=85213366995&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1079542
U2 - 10.3390/toxins16120510
DO - 10.3390/toxins16120510
M3 - Article
C2 - 39728768
AN - SCOPUS:85213366995
SN - 2072-6651
VL - 16
JO - Toxins
JF - Toxins
IS - 12
M1 - 510
ER -
