ABSTRACT

Objective : The objective of this research was to determine the effects of Botulinum toxin A on the arm motor function in chronic spastic hemiplegic patients. Methods : A total of 18 patients who suffered from chronic spastic hemiplegia over 12 months after a brain injury, with wrist and finger strengths of more than a poor minus grade, were enrolled. Botulinum toxin 25 IU (Botox@) was injected into the flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis, and flexor digitorum profundus of each subject's hemiplegic arm. The outcome was assessed by a manual muscle test for arm strength, a dynamometer, a pinch gauge for grip and pinch power, Modified Ashworth Scale (MAS), Manual Function Test (MFT) and CMS10 measuring system for motion analysis at baseline, after 2 weeks, and after an additional 6 weeks of post-injection. Results : After 8 weeks of injection, the subjects’grip and pinch power did not increase significantly. MAS was decreased significantly and wrist extension strength, finger extension strength, and MFT score were increased significantly(p<.05). There were significant improvements in the range of motion score of the passive wrist flexion-active extension movement, as well as in the amplitude of the wrist flexion-extension movement, and hand and finger tap motions (p<.05). Conclusion : A Botulinum toxin injection maybe an effective treatment for spasticity and motor function in chronic spastic hemiplegic patients.