Deans' stroke musings: The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, September 5, 2018

The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients

Looking back at my use of Botox, I really saw no benefit. None of the antagonist muscles to the spastics ones were ever able to overpower the spastic muscles post treatment.

The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients

Takatoshi Hara 1,2,*, Masahiro Abo 1, Hiroyoshi Hara 2, Nobuyuki Sasaki 1, Naoki Yamada 1, Masachika Niimi 1 and Yusuke Shimamoto 2 1 Department of Rehabilitaion Medicine, The Jikei University School of Medicine, 1058461 Tokyo, Japan; abo@jikei.ac.jp (M.A.); nobsasa1005@gmail.com (N.S.); mela012921@yahoo.co.jp (N.Y.); pomardon2010@gmail.com (M.N.) 2 Department of Rehabilitaion Medicine, Kikyogahara Hospital 1295, 3996461 Nagano, Japan; hhara448@orange.plala.or.jp (H.H.); shimamoto@keijin-kai.jp (Y.S.) * Correspondence: t_hara1019@jikei.ac.jp
Received: 15 August 2018; Accepted: 30 August 2018; Published: 31 August 2018

Abstract:

Objectives: This study is a retrospective investigation of the effects of repetitive botulinum toxin A therapy (BoNT-A) and intensive rehabilitation (IR) on lower limb spasticity in post-stroke patients. Methods: Thirty-ﬁve post-stroke patients was included in this study and received BoNT-A fortheﬁrsttime. A 12-day in patient protocol was with 4 cycles of the treatment protocol. The severity of spasticity, motor function and brace status were evaluated.
Results: The modiﬁed Ashworth Scale (MAS) score of ankle dorsiﬂexors, range of motion, walking speed and balancing ability were signiﬁcantly improved after cycle1. The improvement of spasticity and motor function was persistent through cycles 2–4. One-third of brace users were able to discontinue the use of a brace. All of these brace users showed a forward gait pattern prior to therapy.
Conclusions: Repeated BoNT-A combined with IR improved lower limb spasticity in post-stroke patients. Our results suggest that patients who show the forward gait pattern prior to therapy may be able to discontinue the use of their brace after therapy.