Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatment

Objective: To evaluate the long-term efficacy of spasticity-corrective surgery and botulinum toxin treatment in patients with upper limb spasticity. Design: Pretest-posttest quasi-experimental study. Patients: Thirty-four patients with disabling spasticity. Methods: Patients were divided into 2 g...

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Main Authors: Therese Ramström, Johanna Wangdell, Carina Reinholdt, Trandur Ulfarsson, Lina Bunketorp Käll
Format: Article
Language:English
Published: Medical Journals Sweden 2025-05-01
Series:Journal of Rehabilitation Medicine - Clinical Communications
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Online Access:https://medicaljournalssweden.se/jrm-cc/article/view/42928
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author Therese Ramström
Johanna Wangdell
Carina Reinholdt
Trandur Ulfarsson
Lina Bunketorp Käll
author_facet Therese Ramström
Johanna Wangdell
Carina Reinholdt
Trandur Ulfarsson
Lina Bunketorp Käll
author_sort Therese Ramström
collection DOAJ
description Objective: To evaluate the long-term efficacy of spasticity-corrective surgery and botulinum toxin treatment in patients with upper limb spasticity. Design: Pretest-posttest quasi-experimental study. Patients: Thirty-four patients with disabling spasticity. Methods: Patients were divided into 2 groups based on their treatment preference: the surgery group, which underwent tendon lengthening/release (n = 17), and the botulinum toxin injection group (n = 17). The primary outcome measure was the Modified Ashworth Scale. Secondary outcomes included range of motion, grip strength, and activity performance. Assessments were conducted at baseline for both groups, at 3 months following botulinum toxin injection, and at 6 months following surgery, with an additional peak-effect evaluation for botulinum toxin at week 5. Results: The surgery group demonstrated significantly greater reductions in composite Modified Ashworth Scale scores, with a mean change of 2.7 (SD 0.8), compared to the botulinum toxin group (1.1, SD 0.6 at peak; 0.3, SD 0.5 at long-term; p < 0.001). Surgery also led to significantly larger improvements in range of motion, grip strength, task performance, and patient satisfaction. While botulinum toxin effects were transient, surgery provided sustained benefits. Conclusion: Spasticity-corrective surgery achieves superior and longer-lasting benefits compared to botulinum toxin treatment in patients with disabling upper limb spasticity.
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issn 2003-0711
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series Journal of Rehabilitation Medicine - Clinical Communications
spelling doaj-art-3bf8e1c7ec764096be070216b8669bdc2025-08-20T03:53:13ZengMedical Journals SwedenJournal of Rehabilitation Medicine - Clinical Communications2003-07112025-05-01810.2340/jrm-cc.v8.42928Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatmentTherese Ramström0Johanna Wangdell1Carina Reinholdt2Trandur Ulfarsson3Lina Bunketorp Käll4Institute of Clinical Sciences, Department of Hand Surgery at Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden; Occupational and physiotherapy department, Sahlgrenska University Hospital/ Mölndal, Mölndal, SwedenInstitute of Clinical Sciences, Department of Hand Surgery at Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden; Occupational and physiotherapy department, Sahlgrenska University Hospital/ Mölndal, Mölndal, SwedenInstitute of Clinical Sciences, Department of Hand Surgery at Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/Mölndal, Mölndal, SwedenInstitute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenCentre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden; Occupational and physiotherapy department, Sahlgrenska University Hospital/ Mölndal, Mölndal, Sweden; Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenObjective: To evaluate the long-term efficacy of spasticity-corrective surgery and botulinum toxin treatment in patients with upper limb spasticity. Design: Pretest-posttest quasi-experimental study. Patients: Thirty-four patients with disabling spasticity. Methods: Patients were divided into 2 groups based on their treatment preference: the surgery group, which underwent tendon lengthening/release (n = 17), and the botulinum toxin injection group (n = 17). The primary outcome measure was the Modified Ashworth Scale. Secondary outcomes included range of motion, grip strength, and activity performance. Assessments were conducted at baseline for both groups, at 3 months following botulinum toxin injection, and at 6 months following surgery, with an additional peak-effect evaluation for botulinum toxin at week 5. Results: The surgery group demonstrated significantly greater reductions in composite Modified Ashworth Scale scores, with a mean change of 2.7 (SD 0.8), compared to the botulinum toxin group (1.1, SD 0.6 at peak; 0.3, SD 0.5 at long-term; p < 0.001). Surgery also led to significantly larger improvements in range of motion, grip strength, task performance, and patient satisfaction. While botulinum toxin effects were transient, surgery provided sustained benefits. Conclusion: Spasticity-corrective surgery achieves superior and longer-lasting benefits compared to botulinum toxin treatment in patients with disabling upper limb spasticity. https://medicaljournalssweden.se/jrm-cc/article/view/42928botulinum toxin injectionmuscle spasticityoutcome assessmentrehabilitationtendon lengthening
spellingShingle Therese Ramström
Johanna Wangdell
Carina Reinholdt
Trandur Ulfarsson
Lina Bunketorp Käll
Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatment
Journal of Rehabilitation Medicine - Clinical Communications
botulinum toxin injection
muscle spasticity
outcome assessment
rehabilitation
tendon lengthening
title Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatment
title_full Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatment
title_fullStr Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatment
title_full_unstemmed Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatment
title_short Long-term efficacy of spasticity-corrective surgery and botulinum toxin injections for upper limb spasticity treatment
title_sort long term efficacy of spasticity corrective surgery and botulinum toxin injections for upper limb spasticity treatment
topic botulinum toxin injection
muscle spasticity
outcome assessment
rehabilitation
tendon lengthening
url https://medicaljournalssweden.se/jrm-cc/article/view/42928
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