The Effects of Botulinum Toxin Injections on Spasticity and Motor Performance in Chronic Stroke with Spastic Hemiplegia
The Effects of Botulinum Toxin Injections on Spasticity and Motor Performance in Chronic Stroke with Spastic Hemiplegia
复制标题
DOI：
10.3390/toxins12080492
复制
发表时间：
2020-08-01
期刊：
影响因子：
4.2
通讯作者：
Li, Sheng
中科院分区：
文献类型：
--
作者：
Chen, Yen-Ting;Zhang, Chuan;Li, Sheng
痉挛肌肉是虚弱的肌肉。众所周知，肌肉无力与运动表现不佳有关。肉毒杆菌神经毒素(BONT)注射被认为是局灶性痉挛的一线治疗方法。本研究的目的是定量研究BONT注射对中风幸存者痉挛的二头肌的力量控制的影响。10名患有痉挛偏瘫的中风幸存者(51.7+/-11.5岁；5名男性)接受了100单位的肌肉毒毒素A或牛二头肌毒素A治疗，参与了这项研究。在注射前1周内(注射前)和注射后3周内(3周)分别进行肘屈肌痉挛评定(改良Ashworth评分和反射扭矩)、屈肘肌力和运动能力评定(肘次最大屈曲力变异性)。正如预期的那样，注射BONT降低了痉挛瘫痪侧的MAS评分和反射扭矩，以及肘屈肌力量。然而，在注射前后，运动性能保持在相似的水平。注射BONT后，对侧手臂的肌肉力量或运动能力没有变化。这项研究的结果提供了证据，表明注射BOT可以减少痉挛和肌肉力量，而减弱的痉挛肌肉的运动能力保持不变。
Spastic muscles are weak muscles. It is known that muscle weakness is linked to poor motor performance. Botulinum neurotoxin (BoNT) injections are considered as the first-line treatment for focal spasticity. The purpose of this study was to quantitatively investigate the effects of BoNT injections on force control of spastic biceps brachii muscles in stroke survivors. Ten stroke survivors with spastic hemiplegia (51.7 +/- 11.5 yrs; 5 men) who received 100 units of incobotulinumtoxinA or onabotulinumtoxinA to the biceps brachii muscles participated in this study. Spasticity assessment (Modified Ashworth Scale (MAS) and reflex torque) and muscle strength of elbow flexors, as well as motor performance assessment (force variability of submaximal elbow flexion) were performed within one week before (pre-injection) and 3 similar to 4 weeks (3-wk) after BoNT injections. As expected, BoNT injections reduced the MAS score and reflex torque, and elbow flexor strength on the spastic paretic side. However, motor performance remained within similar level before and after injections. There was no change in muscle strength or motor performance on the contralateral arm after BoNT injections. The results of this study provide evidence that BoNT injections can reduce spasticity and muscle strength, while motor performance of the weakened spastic muscle remains unchanged.