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Article

A Pilot Randomized Controlled Trial of Botulinum Toxin Treatment Combined with Robot-Assisted Therapy, Mirror Therapy, or Active Control Treatment in Patients with Spasticity Following Stroke

by
Jen-Wen Hung
1,2,
Chu-Ling Yen
3,4,5,*,
Ku-Chou Chang
2,6,7,8,
Wei-Chi Chiang
3,9,
I-Ching Chuang
3,10,11,
Ya-Ping Pong
1,2,
Wen-Chi Wu
1 and
Ching-Yi Wu
3,11,12,*
1
Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
2
School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
3
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
4
School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
5
Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
6
Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
7
Discharge Planning Service Center, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
8
Department of Senior Citizen Service Management, Yuh-Ing Junior College, Kaohsiung 80776, Taiwan
9
Department of Occupational Therapy, I-Shou University, Kaohsiung 82445, Taiwan
10
Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
11
Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan
12
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
 
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Authors to whom correspondence should be addressed.
Toxins 2022, 14(6), 415; https://doi.org/10.3390/toxins14060415
Submission received: 26 May 2022 / Revised: 12 June 2022 / Accepted: 14 June 2022 / Published: 17 June 2022
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Abstract

Effects of the combined task-oriented trainings with botulinum toxin A (BoNT-A) injection on improving motor functions and reducing spasticity remains unclear. This study aims to investigate effects of 3 task-oriented trainings (robot-assisted therapy (RT), mirror therapy (MT), and active control treatment (AC)) in patients with stroke after BoNT-A injection. Thirty-seven patients with chronic spastic hemiplegic stroke were randomly assigned to receive RT, MT, or AC following BoNT-A injection over spastic upper extremity muscles. Each session of RT, MT, and AC was 75 min, 3 times weekly, for 8 weeks. Outcome measures were assessed at pretreatment, post-treatment, and 3-month follow-up, involving the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), Motor Activity Log (MAL), including amount of use (AOU) and quality of movement (QOM), and arm activity level. All 3 combined treatments improved FMA, MAS, and MAL. The AC induced a greater effect on QOM in MAL at the 3-month follow-up than RT or MT. All 3 combined trainings induced minimal effect on arm activity level. Our findings suggest that for patients with stroke who received BoNT-A injection over spastic UE muscles, the RT, MT, or AC UE training that followed was effective in improving motor functions, reducing spasticity, and enhancing daily function.
Keywords: stroke rehabilitation; robot-assisted training; mirror therapy; conventional rehabilitation; upper extremity; motor function stroke rehabilitation; robot-assisted training; mirror therapy; conventional rehabilitation; upper extremity; motor function

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MDPI and ACS Style

Hung, J.-W.; Yen, C.-L.; Chang, K.-C.; Chiang, W.-C.; Chuang, I.-C.; Pong, Y.-P.; Wu, W.-C.; Wu, C.-Y. A Pilot Randomized Controlled Trial of Botulinum Toxin Treatment Combined with Robot-Assisted Therapy, Mirror Therapy, or Active Control Treatment in Patients with Spasticity Following Stroke. Toxins 2022, 14, 415. https://doi.org/10.3390/toxins14060415

AMA Style

Hung J-W, Yen C-L, Chang K-C, Chiang W-C, Chuang I-C, Pong Y-P, Wu W-C, Wu C-Y. A Pilot Randomized Controlled Trial of Botulinum Toxin Treatment Combined with Robot-Assisted Therapy, Mirror Therapy, or Active Control Treatment in Patients with Spasticity Following Stroke. Toxins. 2022; 14(6):415. https://doi.org/10.3390/toxins14060415

Chicago/Turabian Style

Hung, Jen-Wen, Chu-Ling Yen, Ku-Chou Chang, Wei-Chi Chiang, I-Ching Chuang, Ya-Ping Pong, Wen-Chi Wu, and Ching-Yi Wu. 2022. "A Pilot Randomized Controlled Trial of Botulinum Toxin Treatment Combined with Robot-Assisted Therapy, Mirror Therapy, or Active Control Treatment in Patients with Spasticity Following Stroke" Toxins 14, no. 6: 415. https://doi.org/10.3390/toxins14060415

APA Style

Hung, J.-W., Yen, C.-L., Chang, K.-C., Chiang, W.-C., Chuang, I.-C., Pong, Y.-P., Wu, W.-C., & Wu, C.-Y. (2022). A Pilot Randomized Controlled Trial of Botulinum Toxin Treatment Combined with Robot-Assisted Therapy, Mirror Therapy, or Active Control Treatment in Patients with Spasticity Following Stroke. Toxins, 14(6), 415. https://doi.org/10.3390/toxins14060415

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