Deans' stroke musings: Extracorporeal shock waves versus botulinum toxin type A in the treatment of poststroke upper limb spasticity: A randomized noninferiority trial

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, December 19, 2018

Extracorporeal shock waves versus botulinum toxin type A in the treatment of poststroke upper limb spasticity: A randomized noninferiority trial

Hell my doctor knew nothing about botox, my OT had to set it all up. Start learning about this so you can train your doctor.

Extracorporeal shock waves versus botulinum toxin type A in the treatment of poststroke upper limb spasticity: A randomized noninferiority trial

Archives of Physical Medicine and Rehabilitation , Volume 99(11) , Pgs. 2143-2150.

NARIC Accession Number: J79835. What's this?
ISSN: 0003-9993.
Author(s): Wu, Yah-Ting; Yu, Hui-Kung; Chen, Li-Ru; Chang, Chih-Ning; Chen, Yi-Min; Hu, Gwo-Chi.
Publication Year: 2018.
Number of Pages: 12.
Abstract: Study investigated whether extracorporeal shock wave therapy (ESWT) is noninferior to botulinum toxin type A (BoNT-A) for the treatment of poststroke upper-limb spasticity. Forty-two patients with chronic stroke were randomly assigned to either the ESWT or BoNT-A group. During the study period, all patients continued their regular rehabilitation. Assessments were performed at baseline and at 1, 4, and 8 weeks after the intervention. The primary outcome was the change from baseline of the Modified Ashworth Scale (MAS) score of the wrist flexors at week 4. Secondary outcomes included the change of the MAS scores, Tardieu angles of the wrist and elbow flexors, wrist and elbow passive range of motion (PROM), and upper-extremity Fugl-Meyer Assessment (UE-FMA) score during the study period, as well as the treatment response rate. The primary outcome result in the ESWT group (−0.80) was similar to that in the BoNT-A group (−0.90), with a higher confidence limit (0.4) for the difference between groups within the prespecified margin of 0.5, indicating the noninferiority of ESWT to BoNT-A. The response rate was not significantly different between the 2 groups. Both groups showed significant improvement in secondary outcomes relative to baseline; however, the ESWT group yielded greater improvement in wrist and elbow PROM and UE-FMA score. Results suggest that ESWT is a noninferior treatment alternative to BoNT-A for poststroke upper-limb spasticity. ESWT and BoNT-A caused similar reduction in spasticity of the wrist and elbow flexors; however, ESWT yielded greater improvement in wrist and elbow PROM and UE-FMA score.