title: Adhesive taping vs. daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the effectiveness of two procedures increasing the botulinum toxin type A effect for wrist and finger flexor spasticity after stroke.
  
  
  METHODS
  A single-blind randomized trial.
  
  
  METHODS
  Seventy patients with upper limb post-stroke spasticity.
  
  
  METHODS
  Adults with wrist and finger flexor muscles spasticity after stroke were submitted to botulinum toxin type A therapy. After the treatment, the subjects injected were randomly divided into two groups and submitted to adhesive taping (Group A) or daily muscle manual stretching, passive articular mobilization of wrist and fingers, and palmar splint (Group B) for 10 days. We measured spasticity with Modified Ashworth Scale, related disability with Disability Assessment Scale, and fingers position at rest. The measurements were done at baseline, after two weeks, and after one month from the treatment session.
  
  
  RESULTS
  After two weeks, subjects in Group A reported a significantly greater decrease in spasticity scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.3±0.6 vs. 2.1±0.6; Modified Ashworth Scale wrist: 1.7 ±0.6 vs. 2.3 ±0.8), and after one month in spasticity and disability scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.9 ±0.7 vs. 2.5 ±0.6; Modified Ashworth Scale wrist: 2.0 ±0.7 vs. 2.6 ±0.6; Disability Assessment Scale: 1.6 ±0.7 vs. 2.1 ±0.7) compared with Group B subjects. Subjects in Group A reported also a significantly improved fingers position at rest compared with Group B subjects after two weeks (2.8 ±0.9 vs. 2.1 ±0.7) and one month (2.3 ±0.7 vs. 1.5 ±0.6).
  
  
  CONCLUSIONS
  Adhesive taping of wrist and finger flexor muscles appeared to enhance the effect of botulinum toxin type A therapy more than daily manual muscle stretching combined with passive articular mobilization and palmar splint.
authors.affiliation: Department of Physical Medicine and Rehabilitation, "OORR Hospital", University of Foggia, Foggia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Santamato
authors.affiliation: Department of Physical Medicine and Rehabilitation, "OORR Hospital", University of Foggia, Foggia, Italy.
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Micello
authors.affiliation: Neurodegenerative Disease Unit, University of Bari Aldo Moro, Bari, Italy Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Italy geriat.dot@geriatria.uniba.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Panza
authors.affiliation: Section of Hygiene, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Fortunato
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Picelli
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Smania
authors.affiliation: Neurodegenerative Disease Unit, University of Bari Aldo Moro, Bari, Italy Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.affiliation: Section of Physical Medicine and Rehabilitation "Policlinico Hospital", University of Bari, Bari, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Fiore
authors.affiliation: Department of Physical Medicine and Rehabilitation, "OORR Hospital", University of Foggia, Foggia, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ranieri
mesh_terms: D001458:Bandages; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D005260:Female; D005385:Fingers / Q000503:physiopathology; D006801:Humans; D007273:Injections, Intramuscular; D007558:Italy; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology / Q000534:rehabilitation*; D052580:Muscle Stretching Exercises / Q000379:methods*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D010043:Outcome and Process Assessment, Health Care; D016037:Single-Blind Method; D013165:Splints; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D014955:Wrist Joint / Q000187:drug effects / Q000503:physiopathology
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin; disability; splint; stretching; stroke