Deans' stroke musings: Comparing the real-world effectiveness of botulinum toxin type A injections across distinct poststroke muscle hyper-resistance patterns

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.

Monday, July 13, 2026

Comparing the real-world effectiveness of botulinum toxin type A injections across distinct poststroke muscle hyper-resistance patterns

But botox DOES NOTHING TO CURE SPASTICITY!

Obviously these researchers don't think much of the ridiculous opinion of Dr. William M. Landau!

Spasticity After Stroke: Why Bother? Aug. 2004)

Comparing the real-world effectiveness of botulinum toxin type A injections across distinct poststroke muscle hyper-resistance patterns

1. Department of Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China
2. Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, Jilin, China

Abstract

Background:

Post-stroke muscle hyper-resistance is produced by both neurogenic (spasticity) and non-neurogenic (contracture) factors. BoNT-A is the most effective intervention for post-stroke spasticity, yet whether concomitant contracture alters its therapeutic benefit remains unclear.

Aims:

To compare BoNT-A effectiveness in plantar-flexor hyper-resistance stratified by contracture.

Methods:

We retrospectively reviewed stroke survivors with spastic hemiplegia and ankle plantar-flexor hyper-resistance who received BoNT-A injections. Patients were stratified into two groups according to the presence of restricted passive ankle dorsiflexion: the spasticity group (PROM limitation <7°) and the spasticity-with-contracture group (PROM limitation ≥7°). Outcomes were assessed at baseline and at 2, 4 and 12 weeks post-injection, including the Modified Ashworth Scale (MAS) for plantar-flexors, Brunnstrom Recovery Stage (BRS), Fugl–Meyer Assessment (FMA) lower-extremity subscore and Barthel Index (BI).

Results:

A total of 107 patients were enrolled—54 in the spasticity group and 53 in the spasticity-with-contracture group. Baseline comparison revealed a significantly longer disease duration in the spasticity-with-contracture group; other characteristics were comparable. Both groups achieved improvements in MAS and BRS at all three follow-up visits. FMA and BI improved in the spasticity group at 4 and 12 weeks, whereas the spasticity-with-contracture group showed improvement only at 12 weeks. Between-group analyses indicated that MAS and BRS scores were consistently better in the spasticity group at each time point; although median FMA and BI were numerically higher in this group, the differences did not reach statistical significance.

Conclusion:

BoNT-A markedly reduces(NOT CURES!) post-stroke hyper-resistance and enhances motor function and activities of daily living; by contrast, concomitant contracture is associated with delayed and attenuated improvement in MAS and BRS.