title: Botulinum toxin injection of the subscapularis muscle.
abstract: Patients with hemiplegia frequently suffer from pain and have a limited range of motion (ROM) of the shoulder. The common pattern of shoulder movement in a patient with spastic hemiplegia is primarily adduction and internal rotation. Spasticity of the subscapularis muscle limits the abduction, external rotation and flexion of the shoulder. Injection of botulinum toxin or application of phenol can reduce the spasticity of the subscapularis muscle and various techniques to inject this muscle have been reported. We injected five patients with hemiplegia with botulinum toxin using our previously reported inferior approach, which is easy, safe and effective. We observed a reduction in pain and spasticity and improvement in the ROM of the shoulder for all patients.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Yildirim Beyazit Training and Research Hospital, Irfan Baştuğ Cad., Diskapi, Ankara, Turkey. dreceunlu@yahoo.com
authors.forename: Ece
authors.initials: E
authors.lastname: Unlu
authors.forename: Tulin
authors.initials: T
authors.lastname: Sen
authors.forename: Ebru
authors.initials: E
authors.lastname: Umay
authors.forename: Burcu
authors.initials: B
authors.lastname: Bal
authors.forename: Alaittin
authors.initials: A
authors.lastname: Elhan
authors.forename: Aytul
authors.initials: A
authors.lastname: Cakci
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006429:Hemiplegia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology*; D009465:Neuromuscular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016059:Range of Motion, Articular / Q000187:drug effects; D012189:Retrospective Studies; D020069:Shoulder Pain / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A