Sensitivity of the NeuroFlexor method to measure change in spasticity after treatment with botulinum toxin A in wrist and finger muscles.
OBJECTIVE
The NeuroFlexor objectively quantifies the neural, elastic and viscous components of passive movement resistance in wrist and finger flexor muscles. In this study we investigated the sensitivity of the NeuroFlexor to changes in spasticity induced by treatment with botulinum toxin type A (BoNT-A).


METHODS
Prospective observational design.


METHODS
A convenience sample of 22 adults with post-stroke upper limb spasticity scheduled for botulinum toxin treatment.


METHODS
BoNT-A was given according to individual treatment plans. NeuroFlexor assessments were made before treatment and 4 and 12 weeks after.


RESULTS
At group level, spasticity decreased significantly at 4 weeks (expected time of maximum effect) (p = 0.04). At 12 weeks, spasticity had rebounded and no longer differed significantly from baseline (p = 0.64), i.e. in line with the pharmacodynamics of BoNT-A. At the individual level, 7 participants showed a reduction in spasticity greater than the measurement error. The reduction was dose-dependent (r(20) = 0.66, p < 0.001), and largest in participants with the highest dose.


CONCLUSIONS
At the group level, the sensitivity of NeuroFlexor is good enough to detect reduction in spasticity after treatment with BoNT-A. Further work is needed to establish the sensitivity of NeuroFlexor on an individual level.
Department of Women's and Children's Health, Karolinska Institutet, Neuropediatric Research Unit and Stockholm Brain Institute, Astrid Lindgrens Barnsjukhus Q2:07, SE-171 76 Stockholm, Sweden. johan.gaverth@ki.se.
Johan
J
Gäverth
Ann-Christin
AC
Eliasson
Kjell
K
Kullander
Jörgen
J
Borg
Påvel G
PG
Lindberg
Hans
H
Forssberg
D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005385:Fingers; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000534:rehabilitation; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020521:Stroke / Q000188:drug therapy; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014955:Wrist Joint; D055815:Young Adult
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A