Augmenting occupational therapy treatment of upper-extremity spasticity with botulinum toxin A: a case report of progress at discharge and 2 years later.
This case report summarizes occupational therapy services provided to a participant after botulinum toxin A (BTA) injections and her improvements 2 years later. The injections were performed to neutralize spasticity in the left upper extremity after a stroke. Along with BTA, the participant received occupational therapy for 12 weeks, using neurodevelopmental and biomechanical approaches and an activity-based home program. Spasticity decreased from a 4 to a 1 on the Modified Ashworth Scale (MAS) immediately after the injections. Two years after the injections, the MAS score ranged between 1 and 1+. Initially, the participant demonstrated functional limitations in areas of splint application, dressing, toileting, and bathing. Following BTA injections and occupational therapy, the participant demonstrated increased independence in all deficit areas. For this participant, BTA, combined with functional, activity-based occupational therapy interventions, was associated with neurological change and greater functional use of the spastic limb.
Denham
Susan P
SP
College of Health Sciences, Alabama State University, Montgomery, AL 36117, USA. sdenham@alasu.edu
D000203:Activities of Daily Living; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D007273:Injections, Intramuscular; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009788:Occupational Therapy; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A