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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| Language: | English |
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Medical Journals Sweden
2025-05-01
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| 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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| format | Article |
| id | doaj-art-3bf8e1c7ec764096be070216b8669bdc |
| institution | Kabale University |
| issn | 2003-0711 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| 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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