title: Effect of intramuscular botulinum toxin injection on upper limb spasticity in stroke patients.
abstract: OBJECTIVE
  To evaluate the therapeutic effect of intramuscular injection of botulinum toxin on spasticity of the upper limb, with emphasis on its influence over limb function.
  
  
  METHODS
  An open-label, noncontrolled trial with a duration of 12 wk was designed to determine the safety and efficacy of intramuscular botulinum toxin A injection in the treatment of 16 patients with stroke with spastic hemiparesis. Electromyographically guided intramuscular botulinum toxin A injections were applied to the spastic limbs. A detailed scale system was used for the evaluation of muscle tone and functional changes induced by botulinum toxin A treatment.
  
  
  RESULTS
  No major side effect secondary to botulinum toxin A injection was reported. Statistically significant (P < 0.05) improvements of muscle tone, joint range of motion, hand muscle strength, and muscular pain were seen after the injection. The improvements lasted up to 8-12 wk after the treatment. However, there was no significant functional improvement except in two of the patients.
  
  
  CONCLUSIONS
  Botulinum toxin A injection may help relieve upper limb spasticity and pain in patients with stroke. Its effect on function is probably determined by case selection.
authors.affiliation: Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Han-Cheng
authors.initials: HC
authors.lastname: Wang
authors.forename: Lin-Fen
authors.initials: LF
authors.lastname: Hsieh
authors.forename: Wen-Chou
authors.initials: WC
authors.lastname: Chi
authors.forename: Shih-Min
authors.initials: SM
authors.lastname: Lou
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001132:Arm; D019274:Botulinum Toxins, Type A / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D018737:Hand Strength; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D020336:Paraparesis, Spastic / Q000188:drug therapy* / Q000209:etiology; D016059:Range of Motion, Articular / Q000187:drug effects; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A