Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22292
Title: Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke: The InTENSE Trial.
Austin Authors: Lannin, Natasha A;Ada, Louise;English, Coralie;Ratcliffe, Julie;Faux, Steven G;Palit, Mithu;Gonzalez, Senen ;Olver, John;Cameron, Ian;Crotty, Maria
Affiliation: Faculty of Health Sciences (Physiotherapy), The University of Sydney, New South Wales, Australia
Alfred Health, Melbourne, Victoria, Australia
Rehabilitation and Aged Care, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
John Walsh Centre for Rehabilitation Research, The University of Sydney, New South Wales, Australia
Epworth Monash Rehabilitation Medicine Research Unit, Monash University, Melbourne, Victoria, Australia
College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
Sacred Heart Rehabilitation Unit, St Vincent's Hospital, Sydney, New South Wales, Australia
School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
Department of Neurosciences, Central Clinical School (N.A.L.), Monash University, Melbourne, Victoria, Australia
School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, New South Wales, Australia
Alfred Health, Melbourne, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
Issue Date: Feb-2020
metadata.dc.date: 2019-12-09
Publication information: Stroke 2020; 51(2): 556-562
Abstract: Background and Purpose- The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods- We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results- In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, -2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, -0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2-2.7]). Conclusions- Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: ACTRN12615000616572.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22292
DOI: 10.1161/STROKEAHA.119.027602
PubMed URL: 31813359
Type: Journal Article
Subjects: botulinum toxin type A
neuroscience
pain
quality of life
spasticity
wrist
Appears in Collections:Journal articles

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