Bakheit Abdel Magid, Zakine Benjamin, Maisonobe Pascal, Aymard Claire, Fhedoroff Klemens, Hefter Harold, Jacinto Jorge, Jost Wolfgang H, Molteni Franco, Stam Henk, Turner-Stokes Lynne, Wissel Jorg
Stroke Unit, Mount Gould Hospital, Plymouth, UK.
Int J Rehabil Res. 2010 Sep;33(3):199-204. doi: 10.1097/MRR.0b013e328332f5e0.
To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31 countries were studied. Most patients were over 40 years old and had a stroke. Improvement of active function was the most frequent treatment goal in the first 3 months after the onset of upper limb spasticity, but was less common than passive function in the chronic stage. Pain relief was a common goal in both the stages. As a rule, clinicians intended to assess the effectiveness of treatment with impairment level scales. Functional outcome measures seem to be rarely used in clinical practice. The use of these measures should be encouraged to assess whether the reduction in muscle tone translates into functional benefit to patients and their caregivers.
记录目前使用A型肉毒毒素治疗上肢痉挛患者的实际情况，为该领域未来的研究提供参考。我们设计了一项关于当前实际情况的国际横断面非干预性调查。对来自31个国家122个研究中心的974例患者进行了研究。大多数患者年龄超过40岁且患有中风。上肢痉挛发作后的前3个月，改善主动功能是最常见的治疗目标，但在慢性期不如被动功能常见。缓解疼痛在两个阶段都是常见目标。通常，临床医生打算用损伤程度量表评估治疗效果。功能结局指标在临床实践中似乎很少使用。应鼓励使用这些指标来评估肌张力降低是否能转化为对患者及其照料者的功能益处。
