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dc.contributor.authorLannin, Natasha A-
dc.contributor.authorAda, Louise-
dc.contributor.authorEnglish, Coralie-
dc.contributor.authorRatcliffe, Julie-
dc.contributor.authorFaux, Steven G-
dc.contributor.authorPalit, Mithu-
dc.contributor.authorGonzalez, Senen-
dc.contributor.authorOlver, John-
dc.contributor.authorCameron, Ian-
dc.contributor.authorCrotty, Maria-
dc.identifier.citationStroke 2020; 51(2): 556-562-
dc.description.abstractBackground 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: Unique identifier: ACTRN12615000616572.-
dc.subjectbotulinum toxin type A-
dc.subjectquality of life-
dc.titleEffect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke: The InTENSE Trial.-
dc.typeJournal Article-
dc.identifier.affiliationFaculty of Health Sciences (Physiotherapy), The University of Sydney, New South Wales, Australiaen
dc.identifier.affiliationAlfred Health, Melbourne, Victoria, Australiaen
dc.identifier.affiliationRehabilitation and Aged Care, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australiaen
dc.identifier.affiliationJohn Walsh Centre for Rehabilitation Research, The University of Sydney, New South Wales, Australiaen
dc.identifier.affiliationEpworth Monash Rehabilitation Medicine Research Unit, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationCollege of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australiaen
dc.identifier.affiliationSacred Heart Rehabilitation Unit, St Vincent's Hospital, Sydney, New South Wales, Australiaen
dc.identifier.affiliationSchool of Medicine, University of New South Wales, Sydney, New South Wales, Australiaen
dc.identifier.affiliationDepartment of Neurosciences, Central Clinical School (N.A.L.), Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationSchool of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, New South Wales, Australia-
dc.identifier.affiliationAlfred Health, Melbourne, Victoria, Australia-
dc.identifier.affiliationAustin Health, Heidelberg, Victoria, Australia-
dc.type.austinJournal Article-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.cerifentitytypePublications- Medicine-
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