Combined treatment of botulinumtoxin and robot-assisted rehabilitation therapy on poststroke, upper limb spasticity: A case report

Medicine (Baltimore). 2017 Dec;96(51):e9468. doi: 10.1097/MD.0000000000009468.

Abstract

Rationale: Spasticity is a major complication after stroke, and botulinumtoxin A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve voluntary motor control or activities of daily living function of paretic upper limbs. This study investigated whether BoNT-A injection combined with robot-assisted upper limb therapy improves voluntary motor control or functions of upper limbs after stroke.

Patient concerns: Two subacute stroke patients were transferred to the Department of Rehabilitation.

Diagnoses: Patients demonstrated spasticity in the upper extremity on the affected side.

Interventions: BoNT-A was injected into the paretic muscles of the shoulder, arm, and forearm of the 2 patients at the subacute stage. Conventional rehabilitation therapy and robot-assisted upper limb training were performed during the rehabilitation period.

Outcomes: Manual dexterity, grip strength, muscle tone, and activities of daily living function were improved after multidisciplinary rehabilitation treatment.

Lessons: BoNT-A injection in combination with multidisciplinary rehabilitation treatment, including robot-assisted arm training, should be recommended for subacute spastic stroke patients to enhance appropriate motor recovery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arm
  • Botulinum Toxins / therapeutic use*
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / etiology*
  • Muscle Spasticity / rehabilitation
  • Robotics / methods*
  • Stroke / complications*
  • Stroke Rehabilitation / methods*

Substances

  • Botulinum Toxins