title: Effect of botulinum toxin type-A in patients with focal spasticity.
abstract: OBJECTIVE
  To investigate the effect of botulinum toxin type-A (BTX-A) on spasticity and function in patients with focal spasticity.
  
  
  METHODS
  Patients attended to the outpatient clinic of physical medicine and rehabilitation department with a diagnosis of focal spasticity and had BTX-A injections because of spasticty were evaluated for the study. Demographic data, exercise status, orthoses, drugs used for spasticity, functional status, stages of spasticity of muscles before and after 1stand 3rdmonths of BTX-A injection according to Modified Ashworth Scale (MAS) were evaluated retrospectively. MedCalc 11.6 statistical program was used for statistical analyses. Statistical significance was defined as p<0.05.
  
  
  RESULTS
  Forty-nine patients with focal spasticity were recruited for the study (35 men, 14 women). Mean age of the patients was 21.59±20.09 years. The patients had cerebral palsy (CP, n=28), 19 had hemiplegia (n=19) and paraplegia (n=2). Forty-three patients were using orthoses and exercising regularly. Mean Pediatric Functional Independence Measurement (WeeFIM) scores of the patients with CP was 54.82±28.91 and according to the Gross Motor Function Classification System (GMFCS) the patients were in stages 2 (14%), 3 (46%), 4 (11%) and 5 (29%). Mean Functional Independence Measure (FIM) of hemiplegic and paraplegic patients was 80.80±20.88. Brunnstrom staging scores for upper extremity (3.52±0.96), hands (2.68±0.82), lower extremity (4.57±1.01) were calculated. MAS muscles demonstrated statistically significant decrease in spasticity at the end of first and third months (p<0.05).
  
  
  CONCLUSIONS
  We saw a significant decrease in the spasticity of upper and lower extremities in patients with focal spasiticity who received BTX-A injections. We suggest that if BTX-A injections are supported with orthoses and exercise programs, then functional status of the patients would be better.
authors.affiliation: Erenkoy Physical Medicine and Rehabilitation Hospital, Istanbul, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Selimoglu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Karaman Government Hospital, Karaman, Turkey.
authors.forename: Selin Turan
authors.initials: ST
authors.lastname: Turgut
authors.affiliation: Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Akpinar
authors.affiliation: Department of Physical Medicine and Rehabilitation, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Yumusakhuylu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Istanbul Occupational Disease Hospital, Istanbul, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Haliloglu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Bakirkoy Prof. Dr. Mazhar Osman Psychology and Neurology Hospital, Istanbul, Turkey.
authors.forename: Hatice Sule
authors.initials: HS
authors.lastname: Baklacioglu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Afitap
authors.initials: A
authors.lastname: Icagasioglu
keywords: Botulinum toxin type-A; cerebral plasy; hemiplegia; spasticity