Comprehensive Use of Dynamic Electrical Neurostimulation and Botulinum Toxin Therapy in Patients with Post-Stroke Spasticity

J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105189. doi: 10.1016/j.jstrokecerebrovasdis.2020.105189. Epub 2020 Aug 6.

Abstract

Background: Acute cerebrovascular accident poses a threat to the health of the nation. Dynamic electric neurostimulation decreases the excitability of the receptor apparatus, optimize microcirculatory processes, analgesic and antispasmodic effects.

Methods: This article discusses the rehabilitation of 96 men and women with post-stroke spasticity, mean age of 60.51 ± 4.9 years, in the early recovery period after ischemic stroke, randomized into 4 equal groups: Group 1 received botulinum toxin therapy in combination with dynamic electric neurostimulation and basic therapy, including massage and therapeutic exercises; Group 2 -botulinum toxin therapy and basic therapy; Group 3 - dynamic electric neurostimulation and basic therapy; Group 4 - basic therapy only. Study methods included the use of the Modified Asworth Scale to assess spasticity, the Rivemead Motor Assessment test, and goniometry to assess the range of joint movements.

Results: During a three-week observation, it was found that the inclusion of botulinum toxin therapy and dynamic electrical neurostimulation in the standard therapy of post-stroke spasticity in patients after ischemic stroke in the early recovery period contributed to patients' recovery.

Conclusions: Botulinum toxin therapy and dynamic electrical neurostimulation contributed to a more significant decrease in spasticity in the proximal and distal parts of the paretic upper extremity. It is also increased the amplitude of voluntary movements in the affected shoulder, elbow, and wrist joints, compared to the separate use of botulinum toxin therapy and dynamic electric neurostimulation as part of basic rehabilitation.

Keywords: Cerebrovascular accident; Muscle tone; Optimization of microcirculatory processes; Rehabilitation of the upper extremity; Rehabilitation therapy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetylcholine Release Inhibitors / administration & dosage*
  • Acetylcholine Release Inhibitors / adverse effects
  • Aged
  • Botulinum Toxins / administration & dosage*
  • Botulinum Toxins / adverse effects
  • Combined Modality Therapy
  • Electric Stimulation Therapy* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Muscle Spasticity / diagnosis
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / rehabilitation*
  • Range of Motion, Articular
  • Recovery of Function
  • Russia
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / therapy*
  • Stroke Rehabilitation* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Upper Extremity / innervation*

Substances

  • Acetylcholine Release Inhibitors
  • Botulinum Toxins