Effects of Botulinum Toxin A on Arm Motor Function Recovery in Chronic Spastic Hemiplegic Patients (만성 경직성 편마비 환자에서 보툴리눔 독소 근주입 후 상지 운동기능 개선 효과)

Noh Seeung (노세응); Seo, Eun-Jin (서은진); Chong, Bok-Hee (정복희); Min Cheol Joo (주민철)

Effects of Botulinum Toxin A on Arm Motor Function Recovery in Chronic Spastic Hemiplegic Patients

Korean Journal of Occupational Therapy
Abbr : Korean J of Occup Ther
2011, 19(2), pp.53-62
Publisher : Korean Society Of Occupational Therapy
Research Area : Medicine and Pharmacy > Working Therapeutics

Noh Seeung ¹, Seo, Eun-Jin ², Chong, Bok-Hee ³, Min Cheol Joo ²

¹원광대학교
²원광대학병원
³호원대학교

Accredited

ABSTRACT

Objective : The objective of this research was to determine the effects of Botulinum toxin A on the arm motor function in chronic spastic hemiplegic patients. Methods : A total of 18 patients who suffered from chronic spastic hemiplegia over 12 months after a brain injury, with wrist and finger strengths of more than a poor minus grade, were enrolled. Botulinum toxin 25 IU (Botox@) was injected into the flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis, and flexor digitorum profundus of each subject's hemiplegic arm. The outcome was assessed by a manual muscle test for arm strength, a dynamometer, a pinch gauge for grip and pinch power, Modified Ashworth Scale (MAS), Manual Function Test (MFT) and CMS10 measuring system for motion analysis at baseline, after 2weeks, and after an additional 6 weeks of post-injection. Results : After 8 weeks of injection, the subjects’grip and pinch power did not increase significantly. MAS was decreased significantly and wrist extension strength, finger extension strength, and MFT score were increased significantly(p<.05). There were significant improvements in the range of motion score of the passive wrist flexion-active extension movement, as well as in the amplitude of the wrist flexion-extension movement, and hand and finger tap motions (p<.05). Conclusion : A Botulinum toxin injection maybe an effective treatment for spasticity and motor function in chronic spastic hemiplegic patients.

KEYWORDS

Botulinum toxin, Motion analysis, Spastic hemiplegia, Stroke, Upper extremity function

Citation status

* References for papers published after 2023 are currently being built.

[journal] 김미영 / 1994 / 뇌졸중 상지 기능 평가에 대한 고찰 / 대한작업치료학회지 2(1) : 19~26

[book] 권정이 / 2009 / 경직. 고영진, 강세윤, 물리의학과 재활 / 정문각 : 421~434

[book] 이인희 / 2004 / 뇌졸중 재활 / 범문사

[journal] 임승윤 / 2008 / The Effects of Dilution Volume of Botulinum Toxin A on the Spasticity of Children with Cerebral Palsy / Annals of Rehabilitation Medicine / 대한재활의학회 32(3) : 294~299

[journal] 진기은 / 1998 / 흰쥐에 서 보툴리누스독소 근주후 조직병리 및 근섬유전도 검사 소견 / 대한재활의학회지 22(2) : 440~446

[journal] 정복희 / 2002 / 근긴장 이상 환자에게 있어 보툴리눔 독 소 주사 후 작업치료가 손 기능 향상에 미치는 효과 / 대한작업치료학회지 10(2) : 127~134

[journal] 한태륜 / 2001 / 보툴리눔 A형 독소의 희석 용적에 따른 복합근 활동전위의 변화 / Annals of Rehabilitation Medicine / 대한재활의학회 25(2) : 273~277

[journal] Boyd, R / 1999 / Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with Cerebral Palsy / European Journal of Neurology 6(4) : 23~35

[journal] Brashear, A / 2002 / Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after stroke / New England Journal of Medicine 347(6) : 395~400

[journal] Brin, M. F / 1997 / Dosing, administration, and a treatment algorithm for use of botulinum toxin A for adult-onset spasticity / Muscle & Nerve 20(6) : 208~220

[journal] Budzianowska, A. / 2008 / Assessment of rest tremor in parkinson’s disease / Neurologia Neurochirurgia Polska 42(1) : 12~21

[journal] Cauraugh, J / 2000 / Chronic motor dysfunction after stroke: Recovering wrist and finger extension by electromyography-triggered neuromuscular stimulation / Stroke 31(6) : 1360~1364

[journal] Corry, I. S / 1997 / Botulinum toxin A in the hemiplegic upper limb: A double-blind trial / Developmental Medicine and Child Neurology 39(3) : 185~193

[journal] Duncan, P. W / 1994 / Similar motor recovery of upper and lower extremities after stroke / Stroke 25(6) : 1181~1188

[journal] Fulton, J. E / 1998 / Botulinum toxin. The newport beach experience / Dermatologic Surgery 24(11) : 1219~1224

[journal] Hardie, R. J / 2000 / Botulinum toxin in muscle spasticity. Journal of Neurology / Neurosurgery and Psychiatry 68(6) : 689~690

[journal] Holland, R. L. / 1981 / Nerve growth in botulinum toxin poisoned muscles / Neuroscience 6(6) : 1167~1179

[journal] Katz, R. T / 1988 / Management of spasticity / American Journal of Physical Medicine and Rehabilitation 67(3) : 108~116

[journal] Klein, A. W / 1998 / Dilution and storage of botulinum toxin / Dermatologic Surgery 24(11) : 1179~1180

[journal] Lagalla, G / 2000 / Post stroke spasticity management with repeated botulinum injections in the upper limb / American Journal of Physical Medicine and Rehabilitation 79(4) : 377~384

[book] Lance, J. W / 1980 / Spasticity disordered motor control in Symphosium synopsis / Yearbook Medical : 485~494

[journal] Nielson, J. B. / 2007 / The spinal patholphysiology of spasticity from a basic science point of view / Acta Physiologica 189(2) : 171~180

[journal] Sampaio, C / 1997 / Botulinum toxin type A for the treatment of arm and hand spasticity in stroke patients / Clinical Rehabilitation 11(1) : 3~7

[book] Siev, E / 1986 / Perceptual and cognition dysfunction in the adult stroke patient: A manual for evaluation and treatment / Slack

[journal] Sloan, R. L / 1992 / Inter-rater reliability of the modified ashworth scale for spasticity in hemiplegic patients / International Journal of Rehabilitation Research 15(2) : 158~161

[journal] Yablon, S. A / 1996 / Botulinum toxin in severe upper extremity spasticity among patients with traumatic brain injury: An open-labeled trial / Neurology 47(4) : 939~943

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