Aygün Bilecik Nilüfer, Tuna Serpil, Karataş Özlem, Balcı Nilüfer
Physical Medicine and Rehabilitation, Adana City Hospital, Health Sciences University, 01230 Adana, Turkey.
Physical Medicine and Rehabilitation, Faculty of Medicine, Akdeniz University, 07058 Antalya, Turkey.
J Clin Med. 2025 Apr 16;14(8):2735. doi: 10.3390/jcm14082735.
Spasticity is a muscle stiffness issue often caused by spinal cord or cerebral diseases, notably impairing stroke patients. This study aims to evaluate the long-term effectiveness of repeated Botulinum Toxin A injections on spasticity and arm function, to understand if the treatment's effects accumulate or diminish over time. This study examines 85 stroke patients treated with one or five sessions of BTX-A injections between 2013 and 2019. Patients were divided into two groups based on the number of sessions and evaluated using Modified Ashworth Scores, Brunnstrom Stage, and Frenchay Arm Test. This study includes 85 hemiplegic patients with an average age of around 50, and various muscle groups were treated with BTX-A injections. Group 2, who received five sessions, showed significantly greater improvement in MAS scores for certain muscle groups and had higher FAT scores compared to Group 1, who received just one session. Overall, BTX-A treatment led to significant improvements in MAS, Brunnstrom, and FAT scores across all patients. Our findings corroborate existing literature by affirming that Botox injections effectively mitigate spasticity and enhance arm functionality. Notably, our data reveal that repeated Botox treatments yield significantly greater benefits in reducing spasticity in the elbow pronators, wrists, and finger flexors compared to a single session. This study uniquely demonstrates the cumulative benefits of multiple BTX-A sessions, highlighting that repeated applications not only sustain but also amplify functional improvements over time. These results advocate for the feasibility and augmented effectiveness of administering a series of five Botox injections in the management of post-stroke spasticity.
痉挛是一种肌肉僵硬问题，通常由脊髓或脑部疾病引起，对中风患者影响尤为明显。本研究旨在评估重复注射A型肉毒杆菌毒素对痉挛和手臂功能的长期疗效，以了解治疗效果随时间推移是累积还是减弱。本研究调查了2013年至2019年间接受过1次或5次BTX-A注射治疗的85名中风患者。根据注射次数将患者分为两组，并使用改良Ashworth评分、Brunnstrom分期和Frenchay手臂测试进行评估。本研究纳入了85名平均年龄约50岁的偏瘫患者，对多个肌肉群进行了BTX-A注射治疗。接受5次注射的第2组在某些肌肉群的MAS评分上改善更为显著，且与仅接受1次注射的第1组相比，FAT评分更高。总体而言，BTX-A治疗使所有患者的MAS、Brunnstrom和FAT评分均有显著改善。我们的研究结果证实了现有文献，即肉毒杆菌毒素注射能有效减轻痉挛并增强手臂功能。值得注意的是，我们的数据显示，与单次注射相比，重复注射肉毒杆菌毒素在减轻肘旋前肌、手腕和手指屈肌的痉挛方面产生的益处要大得多。本研究独特地证明了多次BTX-A注射的累积益处，突出表明随着时间的推移，重复注射不仅能维持功能改善，还能增强这种改善效果。这些结果支持了在中风后痉挛管理中进行一系列5次肉毒杆菌毒素注射的可行性和增强的有效性。
