title: Short Form 36 assessed health-related quality of life after focal spasticity therapy.
abstract: OBJECTIVE
  Analysis of the impact of an individualized comprehensive focal spasticity management on health-related quality of life.
  
  
  METHODS
  Prospective observational and interventional 12-week trial in a single-centre rehabilitation outpatient clinic.
  
  
  METHODS
  Forty-one adult patients with upper motor neurone lesions (23 men), mean age 52 (standard deviation 13) years; 27 stroke, 7 cerebral palsy and 7 miscellaneous diagnoses.
  
  
  METHODS
  Patients were assessed using the Short Form 36 (SF-36) Questionnaire before and after intramuscular injections of botulinum toxin type A combined with physical interventions. Spasticity was assessed with the Ashworth Scale (0-4). A verbal scale for patients' self-report of therapy effect was also used.
  
  
  RESULTS
  Significant improvement was found in 3 of 8 SF-36 health scales: social (p = 0.008) and physical functioning (p = 0.026), and role physical (p = 0.048). Spasticity improved significantly (mean 1.1, p < 0.001). Improvement according to the verbal scale was observed for 57 (86%) indications (overall improvement in 36 patients, 88%).
  
  
  CONCLUSIONS
  Comprehensive focal spasticity management with botulinum toxin type A intramuscular injections and physical interventions can improve patients' perceived health-related quality of life in addition to objectively and subjectively measured motor functions.
authors.affiliation: Division of Rehabilitation Medicine, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden. ulla.bergfeldt@ds.se
authors.forename: Ulla
authors.initials: U
authors.lastname: Bergfeldt
authors.forename: Camilla
authors.initials: C
authors.lastname: Sköld
authors.forename: Per
authors.initials: P
authors.lastname: Julin
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000150:complications / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000150:complications / Q000534:rehabilitation; D009128:Muscle Spasticity / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D011788:Quality of Life; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A