title: Botulinum toxin in upper limb spasticity after acquired brain injury: a randomized trial comparing dilution techniques.
abstract: OBJECTIVE
  To compare the efficacy of two different volume preparations of the same dose of botulinum toxin-A in relieving spasticity in wrist and finger flexors secondary to acquired brain injury.
  
  
  METHODS
  Thirteen adult patients who had modified Ashworth scale scores of 3 for both wrist and finger flexors were included in this randomized, controlled trial. Wrist and finger flexors were each injected. Blinded modified Ashworth scale ratings of wrist and finger flexor spasticity were measured.
  
  
  RESULTS
  Spasticity in both muscles decreased significantly in both treatment groups. However, the high-volume and low-volume groups did not differ significantly in spasticity reduction.
  
  
  CONCLUSIONS
  Because this preliminary study found no difference in spasticity reduction between high- and low-volume preparations of a 60-unit dose of botulinum toxin-A, a larger-sample study seems warranted to compare the efficacy of high-volume and low-volume preparations.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Texas-Houston Medical School, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Gerard E
authors.initials: GE
authors.lastname: Francisco
authors.forename: Corwin
authors.initials: C
authors.lastname: Boake
authors.forename: Amy
authors.initials: A
authors.lastname: Vaughn
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications; D005260:Female; D005385:Fingers; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D018482:Muscle, Skeletal / Q000187:drug effects; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications; D016896:Treatment Outcome; D014953:Wrist
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A