Document Detail

Patient Registry of Outcomes in Spasticity Care.
MedLine Citation:
PMID:  22469872     Owner:  NLM     Status:  Publisher    
OBJECTIVE: This study aimed to provide clinical injection data and real-world patient-reported and clinical outcomes for the chemodenervation and neurolytic treatment of muscle overactivity including spasticity in patients with traumatic brain injury and stroke. DESIGN: This study used a prospective multicenter observational design. The participants were 487 patients with stroke or traumatic brain injury. The interventions used were onabotulinumtoxin A or phenol. Nine subjects received both onabotulinumtoxin A and phenol. The main outcome measures were satisfaction and goal attainment, pain, and Ashworth Scale scores. RESULTS: The most commonly treated pattern of dysfunction in the upper limb was the flexed wrist, with the flexor carpi radialis as the most frequently treated muscle. The mean total dose for the upper limb muscle was 57.7 ± 34.1 U, and phenol volume was 3.9 ± 0.7 ml. The most commonly treated pattern of dysfunction in the lower limb was the equinovarus/equinus foot, with the medial/lateral gastrocnemius as the most frequently treated muscles. The mean total dose for the lower limb muscle was 93.8 ± 63.5 U, and phenol volume was 4.1 ± 1.3 ml. There was a significant improvement in Ashworth Scale and pain scores. Generally, the patients reported that they were satisfied with their treatment and made progress toward their goals. No significant treatment-related adverse effects were reported. CONCLUSIONS: Based on 487 patients with stroke and traumatic brain injury who were selected by their physician and clinical presentation for treatment using chemodenervation and neurolysis, this report of injection data reflecting actual clinical practice may serve as a further clinical guide in the management of patients with muscle overactivity, including spasticity.
Alberto Esquenazi; Nathaniel Mayer; Stella Lee; Allison Brashear; Elie Elovic; Gerard E Francisco; Stuart Yablon;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-30
Journal Detail:
Title:  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists     Volume:  -     ISSN:  1537-7385     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-4-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803677     Medline TA:  Am J Phys Med Rehabil     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the Gait and Motor Control Analysis Laboratories, MossRehab, Elkins Park, Pennsylvania (AE, NM, SL); Department of Neurology, Wake Forest University, Winston Salem, North Carolina (AB); Department of PM&R, University of Utah, Salt Lake City, Utah (EE); Department of PM&R, University of Texas Health Science Center and TIRR Memorial Hermann, Houston, Texas (GEF); and Baylor University, Texas Methodist Rehab Center, Dallas, Texas (SY).
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