[Comparative analysis of occupational therapy benefits in spastic patients with hands involvement before and after botulinum toxin infiltration].
BACKGROUND
Spasticity is the most difficult motor disorder to be treated after an encephalic vascular accident or stroke, which interferes in the patient's selective motor functioning.


OBJECTIVE
To compare the involvement type of the extrinsic muscles, the functionality degree of the hand and functional independence of patients with spastic hemiplegia due to stroke after botulinum toxin A (BTA) infiltration. They were divided into a group receiving occupational therapy treatment (group I), and other who has not received it (group II).


METHODS
Longitudinal study with 20 spastic hemiplegic outpatients due to stroke, both sexes, with average age of 53.1 +/- 15.3 years-old who have been attending in the botulinum toxin service. They have received BTA infiltration in the muscles responsible for the hand functional movements, and they were evaluated before and after 3-months infiltration. To collect data, these instruments were used: anamnesis questionnaire of occupational therapy, the Classification of involvement types of extrinsic muscle, according to adapted Zancolli, the adapted Hausen's Functional Classification, the Functional Independence Measure Scale, the Rivermead's Scale of Activity of Daily Life and the Barthel Index.


RESULTS
In the classification, according to adapted Zancolli, group I presented higher improvement of involvement than group II. Statistical significance (p < 0.05) was observed in group I according to the other evaluations, except in the Barthel Index.


CONCLUSIONS
Both effectiveness and importance of occupational therapy were observed in the rehabilitation of patients with spastic hemiplegia due to stroke after infiltration of BTA providing them greater abilities and functional independence in their daily life activities.
Rampazo
F M
FM
Facultade de Medicina de Sao Jose de Rio Preto, Brasil. frampazo@yahoo.com.br
Bianchin
M A
MA
Oliveira
F N
FN
Lucato
R V
RV
D000328:Adult; D000368:Aged; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006429:Hemiplegia / Q000188:drug therapy* / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins