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Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia

The short-term effects of botulinum toxin type A (BoNT-A) treatment in stroke patients with upper extremity are well established. This study examined the association between the recovery of motor function of the upper extremity with subjective physical symptoms in outpatients receiving long-term BoN...

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Autores principales: Hamaguchi, Toyohiro, Abo, Masahiro, Murata, Kai, Kenmoku, Mari, Yoshizawa, Izumi, Ishikawa, Atsushi, Suzuki, Makoto, Nakaya, Naoki, Taguchi, Kensuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723584/
https://www.ncbi.nlm.nih.gov/pubmed/31382438
http://dx.doi.org/10.3390/toxins11080453
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author Hamaguchi, Toyohiro
Abo, Masahiro
Murata, Kai
Kenmoku, Mari
Yoshizawa, Izumi
Ishikawa, Atsushi
Suzuki, Makoto
Nakaya, Naoki
Taguchi, Kensuke
author_facet Hamaguchi, Toyohiro
Abo, Masahiro
Murata, Kai
Kenmoku, Mari
Yoshizawa, Izumi
Ishikawa, Atsushi
Suzuki, Makoto
Nakaya, Naoki
Taguchi, Kensuke
author_sort Hamaguchi, Toyohiro
collection PubMed
description The short-term effects of botulinum toxin type A (BoNT-A) treatment in stroke patients with upper extremity are well established. This study examined the association between the recovery of motor function of the upper extremity with subjective physical symptoms in outpatients receiving long-term BoNT-A and occupational therapy following stroke. We also investigated the expectations of patients who elected to continue treatment. Forty-seven patients (23 men and 24 women) aged 61 years received BoNT-A treatment more than 20 times. The subjective physical status was analyzed by using the visual analogue scale score through an eight-item questionnaire. Recovery of motor function in the upper extremity was detected by calculating the change (delta) in Fugl–Mayer Assessment (FMA), and ordinal logistic modeling analysis was used to determine the association between the delta-FMA score and the subjective level of agreement for each item. When the ordinal logistic modeling fit was statistically significant, results were interpreted as having logistic probability. The logistic curves discriminating one point (strongly disagree) from five points (strongly agree) were fit in a stepwise fashion. This study suggests that patients receiving long-term BoNT-A treatment and occupational therapy experienced an increased upper extremity mitigation and decreased insomnia after injection, regardless of the recovery of motor function.
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spelling pubmed-67235842019-09-10 Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia Hamaguchi, Toyohiro Abo, Masahiro Murata, Kai Kenmoku, Mari Yoshizawa, Izumi Ishikawa, Atsushi Suzuki, Makoto Nakaya, Naoki Taguchi, Kensuke Toxins (Basel) Article The short-term effects of botulinum toxin type A (BoNT-A) treatment in stroke patients with upper extremity are well established. This study examined the association between the recovery of motor function of the upper extremity with subjective physical symptoms in outpatients receiving long-term BoNT-A and occupational therapy following stroke. We also investigated the expectations of patients who elected to continue treatment. Forty-seven patients (23 men and 24 women) aged 61 years received BoNT-A treatment more than 20 times. The subjective physical status was analyzed by using the visual analogue scale score through an eight-item questionnaire. Recovery of motor function in the upper extremity was detected by calculating the change (delta) in Fugl–Mayer Assessment (FMA), and ordinal logistic modeling analysis was used to determine the association between the delta-FMA score and the subjective level of agreement for each item. When the ordinal logistic modeling fit was statistically significant, results were interpreted as having logistic probability. The logistic curves discriminating one point (strongly disagree) from five points (strongly agree) were fit in a stepwise fashion. This study suggests that patients receiving long-term BoNT-A treatment and occupational therapy experienced an increased upper extremity mitigation and decreased insomnia after injection, regardless of the recovery of motor function. MDPI 2019-08-02 /pmc/articles/PMC6723584/ /pubmed/31382438 http://dx.doi.org/10.3390/toxins11080453 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hamaguchi, Toyohiro
Abo, Masahiro
Murata, Kai
Kenmoku, Mari
Yoshizawa, Izumi
Ishikawa, Atsushi
Suzuki, Makoto
Nakaya, Naoki
Taguchi, Kensuke
Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
title Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
title_full Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
title_fullStr Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
title_full_unstemmed Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
title_short Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
title_sort association of long-term treatment by botulinum neurotoxins and occupational therapy with subjective physical status in patients with post-stroke hemiplegia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723584/
https://www.ncbi.nlm.nih.gov/pubmed/31382438
http://dx.doi.org/10.3390/toxins11080453
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