ASSESSMENT OF THE DYNAMICS OF THE FUNCTIONAL STATE OF POST-STROKE PATIENTS WITH SPASTIC HEMIPARESIS IN THE COURSE OF REHABILITATION INTERVENTIONS

Abstract

The article describes the assessment of the dynamics of the functional state of post-stroke 62 patients with spastic hemiparesis in the course of rehabilitational interventions (Group 1) and a combination of rehabilitational interventions and botulinum therapy (Group 2). A positive dynamics of the functional state was revealed in both patient groups. However, a reduction in the level of spasticity and an amelioration of the functioning of paretic extremities were more significant in the patient group treated with botulotoxinum type A.

Keywords

stroke / spastic hemiparesis / rehabilitation / botulinum therapy

References

[1] Гусев Е.И., Скворцова Е.И., Стаховская Л.В. и др. Эпидемиология инсульта в России // Consilium medicum, журнал доказательной медицины для практикующих врачей, специальный выпуск. - Проблемы цереброваскулярной патологии и инсульта. 2003. С. 5-7.

[2] Захаров Д.В., Балунов О.А. Динамика показателей функционального состояния и качества жизни у пациентов с дисциркуляторной энцефалопатией в процессе лечения // Обозрение психиатрии и медицинской психологии им. В.М. Бехтерева. 2007. Т. 4, № 2. С. 10-12.

[3] Кадыков А. С., Черникова Л. А., Шахпаронова Н.В. Реабилитация неврологических больных. М.: Медпресс-информ. 2009. 560 с.

[4] Ashford S., Turner-Stokes L. Goal attainment for spasticity management using botulinum toxin // Physiother Res Int. 2006. Vol. 11. P. 24-34.

[5] Bakheit A.M., Pittock S., Moore A.P. et al. A randomized, double-blind, placebo-controlled study of the efficacy and safety of botulinum toxin type A in upper limb spasticity in patients with stroke // Eur. J. Neurol. 2001. Vol. 8. P. 559-565.

[6] Bakheit A.M., Thilmann A.F., Ward A.B. et al. A randomized, double-blind, placebo-controlled, dose-ranging study to compare the efficacy and safety of three doses of botulinum toxin type A (Dysport) with placebo in upper limb spasticity after stroke // Stroke. 2000. Vol. 31. P. 2402-2406.

[7] Bayram S., Sivrioglu K., Karli N., Ozcan O. Low-dose botulinum toxin with short-term electrical stimulation in poststroke spastic drop foot: a preliminary study // Am. J. Phys. Med. Rehabil. 2006. Vol. 85. P. 75-81.

[8] Bleyenheuft C., Cockx S., Caty G. et al. The effect of botulinum toxin injections on gait control in spastic stroke patients presenting with a stiff-knee gait// Gait and Posture. 2009. Vol. 30 (2). P. 168-172.

[9] Brock K., Black S., Cotton S. et al. Goal achievement in the six months after inpatient rehabilitation for stroke // Disabil Rehabil. 2009. Vol. 31. P. 880-886.

[10] Childers M.K., Brashear A., Jozefczyk P. et al. Dose-dependent response to intramuscular botulinum toxin type A for upper- limb spasticity in patients after a stroke // Arch. Phys. Med. Rehabil. 2004. Vol. 85. P. 1063-1069.

[11] De Boer K.S., Arwert H.J., De Groot J.H. et al. Shoulder pain and external rotation in spastic hemiplegia do not improve by injection of botulinum toxin A into the subscapular muscle // J. Neurol. Neurosurg. Psychiatry. 2008. Vol. 79. P. 581-583.

[12] Doan Q.V., Brashear A., Gillard P.J. et al. Relationship between disability and health- related quality of life and caregiver burden in patients with upper limb poststroke spasticity // Polymyalgia Rheumatica. 2012. Vol. 4. P. 4-10.

[13] Elia A.E., Filippini G., Calandrella D., Albanese A. Botulinum neurotoxins for post-stroke spasticity in adults: a systematic review // Mov. Disord. 2009. Vol. 24. P. 801-812.

[14] Elovic E.P., Brashear A., Kaelin D. et al. Repeated treatments with botulinum toxin type a produce sustained decreases in the limitations associated with focal upper-limb poststroke spasticity for caregivers and patients // Arch. Phys. Med. Rehabil. 2008. Vol. 89. P. 799-806.

[15] Francis H.P., Wade D.T., Turner-Stokes L. et al. Does reducing spasticity translate into functional benefit? An exploratory meta-analysis // J. Neurol. Neurosurg. Psychiatry. 2004. Vol. 75. P. 1547-1551.

[16] Jahangir A.W., Tan H.J., Norlinah M.I. et al. Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after stroke // Med. J. Malaysia. 2007. Vol. 62. P. 319-322.

[17] Kaji R., Osako Y., Suyama K. et al. Botulinum toxin type A in post-stroke upper limb spasticity // Curr. Med. Res. Opin. 2010. Vol. 26. P. 1983-1992.

[18] Kong K.H., Neo J.J., Chua K.S. A randomized controlled study of botulinum toxin A in the treatment of hemiplegic shoulder pain associated with spasticity // Clin. Rehabil. 2007. Vol. 21. P. 28-35.

[19] Lance J.W. The control of muscle tone, reflexes, and movement: Robert Wartenberg Lecture // Neurology. 1980. Vol. 30, № 12. P. 1303-1313.

[20] Mancini F., Sandrini G., Moglia A. et al. A randomised, double-blind, dose- ranging study to evaluate efficacy and safety of three doses of botulinum toxin type A (Botox) for the treatment of spastic foot // Neurol Sci. 2005. Vol. 26. P. 26-31.

[21] McCrory P., Turner-Stokes L., Baguley I.J. et al. Botulinum toxin A for treatment of upper limb spasticity following stroke: A multicentre randomized placebo-controlled study of the effects on quality of life and other person-centred outcomes // Journal of Rehabilitation Medicine. 2009. Vol. 41. P. 536-544.

[22] Meythaler J.M., Vogtle L., Brunner R.C. A preliminary assessment of the benefits of the addition of botulinum toxin a to a conventional therapy program on the function of people with longstanding stroke // Arch. Phys. Med. Rehabil. 2009. Vol. 90. P. 1453-1461.

[23] Pittock S.J., Moore A.P., Hardiman O. et al. A double- blind randomised placebo-controlled evaluation of three doses of botulinum toxin type A (Dysport) in the treatment of spastic equinovarus deformity after stroke // Cerebrovasc Dis. 2003. Vol. 15. P. 289-300.

[24] Royal College of physicians, the Intercollegiate Stroke Working party. National clinical guideline for stroke. Third edition. London: RCp, 2008.

[25] Simpson D.M., Gracies J.M., Graham K., et al. Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review) // Neurology. 2009. Vol. 73. P. 736-737; author reply 737-738.

[26] Shaw L.C., Price C.I., Van Wijck F.M. et al. Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial: effect on impairment, activity limitation, and pain // Stroke. 2011. Vol. 42. P. 1371-1379.

[27] Suputtitada A., Suwanwela N.C. The lowest effective dose of botulinum A toxin in adult patients with upper limb spasticity // Disabil Rehabil. 2005. Vol. 27. P. 176-184.

[28] Van Kuijk A.A., Geurts A.C., Bevaart B.J., van Limbeek J. Treatment of upper extremity spasticity in stroke patients by focal neuronal or neuromuscular blockade: a systematic review of the literature // J. Rehabil. Med. 2002. Vol. 34. P. 51-61.

[29] Yelnik A.P., Colle F.M., Bonan I.V., Vicaut E. Treatment of shoulder pain in spastic hemiplegia by reducing spasticity of the subscapular muscle: a randomised, double blind, placebo controlled study of botulinum toxin A // J. Neurol. Neurosurg. Psychiatry. 2007. Vol. 78. P. 845-848.

RIGHTS & PERMISSIONS

Mikhailov V.A., Zakharov D.V., Dyagileva J.I.