Department of Orthopaedics and Rehabilitation, Rehabilitation Unit "S. Niarchos" and.
Disabil Rehabil. 2014;36(4):313-8. doi: 10.3109/09638288.2013.791727. Epub 2013 May 14.
To compare the effects of botulinum toxin injection with and without needle electromyographic guidance for the treatment of spasticity.
A randomized controlled study was conducted in a tertiary university hospital. Twenty-seven adult hemiplegic patients with spasticity due to brain or spinal cord damage were included. Spastic muscles were injected with botulinum toxin with or without EMG guidance. The modified Ashworth scale and modified Barthel index in each patient pre- and post-injection were documented.
In group A, which consisted of 15 patients (55.55%), the injection was administered with needle electromyographic guidance, while in 12 patients (44.44%) of group B without electromyographic guidance with the use of anatomic landmarks only. The follow-up period was 3 months. At 3 weeks post-injection, spasticity was decreased (p < 0.05) in all patients and the mean (SD) reduction of spasticity was higher (p < 0.05) in group A (1.67 (0.5)) than group B (1.25 (0.46)). Similarly, the mean (SD) functional modified Barthel index improved statistically significantly (p < 0.001) post-injection (45.37 (8.43)) than pre-injection (54.07 (9.610), especially in group A (p < 0.05).
The effectiveness of intramuscular botulinum toxin injection for the treatment of spasticity in hemiplegic patients is superior when performed with needle electromyographic guidance than without electromyography.
It is recommended that botulinum toxin muscle injections of hemiplegic limbs be performed with EMG guidance More spasticity reduction and functional improvement at 3 months post-injection was observed in patients injected with botulinum toxin by the use of combined EMG guidance and anatomic landmarks EMG guidance might also save amount of botulinum toxin due to less spasticity observed during injection than when injection is performed with anatomic landmarks only.
比较有针肌电图引导和无针肌电图引导的肉毒毒素注射治疗痉挛的效果。
在一家三级大学医院进行了一项随机对照研究。纳入了 27 名因脑或脊髓损伤导致痉挛的成年偏瘫患者。痉挛肌肉注射肉毒毒素，有或无肌电图引导。记录每位患者注射前后改良 Ashworth 量表和改良巴氏指数。
A 组 15 例（55.55%）患者采用针肌电图引导注射，B 组 12 例（44.44%）患者仅采用解剖标志无肌电图引导。随访期为 3 个月。注射后 3 周，所有患者的痉挛均减轻（p<0.05），A 组（1.67（0.5））痉挛减轻的平均值（标准差）高于 B 组（1.25（0.46））（p<0.05）。同样，注射后功能改良巴氏指数的平均值（标准差）也显著改善（p<0.001）（45.37（8.43）），优于注射前（54.07（9.610）），尤其是 A 组（p<0.05）。
与无肌电图引导相比，在偏瘫患者中，有针肌电图引导的肌内肉毒毒素注射治疗痉挛的效果更好。
建议对偏瘫肢体的肉毒毒素肌内注射进行肌电图引导。在使用肌电图引导和解剖标志相结合的方法注射肉毒毒素的患者中，在注射后 3 个月观察到更多的痉挛减轻和功能改善。与仅使用解剖标志进行注射相比，肌电图引导在注射过程中观察到的痉挛程度较低，因此可能会节省肉毒毒素的用量。
