Limits...
Botulinum Toxin (BT) injection improves voluntary motor control in selected patients with post-stroke spasticity.

Chang SH, Francisco GE, Li S - Neural Regen Res (2012)

Bottom Line: She sustained a hemorrhagic right middle cerebral artery stroke 5 years ago that resulted in finger flexor spasticity and residual weak finger/wrist extension.Botulinum toxin injections led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks.This case report demonstrated that Botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

View Article: PubMed Central - PubMed

Affiliation: UT Health Motor Recovery Laboratory at The Institute for Rehabilitation and Research (TIRR), Memorial Hermann Hospital, Houston, Texas, 77030, USA ; Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, Texas, 77030, USA.

ABSTRACT
The effect of Botulinum Toxin Type A injection on voluntary grip control was examined in a 53-year-old female. She sustained a hemorrhagic right middle cerebral artery stroke 5 years ago that resulted in finger flexor spasticity and residual weak finger/wrist extension. The patient received 50 units of botulinum toxin type A injections each to the motor points (2 sites each muscle) of left flexor digitorum superficialis and flexor digitorum profundus. Botulinum toxin injections led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks. Improved release time was accompanied by shortened extensor EMG activity. Improvement in release time was possibly related to block co-contraction of finger flexors during voluntary finger extension. This case report demonstrated that Botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

No MeSH data available.


Related in: MedlinePlus

A representative electromyography of flexor digitorum superficialis (FDS) and extensor digitorum communis (EDC) before and 10 days after botulinum toxin injection.The subject was asked to grip as soon and as hard as possible after the “grip” signal and relax after the “release” signal (dash lines). The release delay time decreases after injection, along with shortened EDC activities.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4066970&req=5

Figure 1: A representative electromyography of flexor digitorum superficialis (FDS) and extensor digitorum communis (EDC) before and 10 days after botulinum toxin injection.The subject was asked to grip as soon and as hard as possible after the “grip” signal and relax after the “release” signal (dash lines). The release delay time decreases after injection, along with shortened EDC activities.

Mentions: Delays in grip initiation and release were determined from the FDS EMG. The Teager-Kaiser energy operator was used to analyze surface EMG to improve the signal-to-noise ratio, as well as to optimize EMG onset/offset detection[9]. The baseline FDS EMG was calculated as values for the EMG averaged across a 0.5-second window during the initial resting period of each trial. The FDS EMG onset time was identified when the EMG value increased more than the mean value plus 3 standard deviations of the baseline values. Grip initiation delay was calculated as the time difference between EMG onset and the “start” audible tone (Figure 1).


Botulinum Toxin (BT) injection improves voluntary motor control in selected patients with post-stroke spasticity.

Chang SH, Francisco GE, Li S - Neural Regen Res (2012)

A representative electromyography of flexor digitorum superficialis (FDS) and extensor digitorum communis (EDC) before and 10 days after botulinum toxin injection.The subject was asked to grip as soon and as hard as possible after the “grip” signal and relax after the “release” signal (dash lines). The release delay time decreases after injection, along with shortened EDC activities.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4066970&req=5

Figure 1: A representative electromyography of flexor digitorum superficialis (FDS) and extensor digitorum communis (EDC) before and 10 days after botulinum toxin injection.The subject was asked to grip as soon and as hard as possible after the “grip” signal and relax after the “release” signal (dash lines). The release delay time decreases after injection, along with shortened EDC activities.
Mentions: Delays in grip initiation and release were determined from the FDS EMG. The Teager-Kaiser energy operator was used to analyze surface EMG to improve the signal-to-noise ratio, as well as to optimize EMG onset/offset detection[9]. The baseline FDS EMG was calculated as values for the EMG averaged across a 0.5-second window during the initial resting period of each trial. The FDS EMG onset time was identified when the EMG value increased more than the mean value plus 3 standard deviations of the baseline values. Grip initiation delay was calculated as the time difference between EMG onset and the “start” audible tone (Figure 1).

Bottom Line: She sustained a hemorrhagic right middle cerebral artery stroke 5 years ago that resulted in finger flexor spasticity and residual weak finger/wrist extension.Botulinum toxin injections led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks.This case report demonstrated that Botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

View Article: PubMed Central - PubMed

Affiliation: UT Health Motor Recovery Laboratory at The Institute for Rehabilitation and Research (TIRR), Memorial Hermann Hospital, Houston, Texas, 77030, USA ; Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, Texas, 77030, USA.

ABSTRACT
The effect of Botulinum Toxin Type A injection on voluntary grip control was examined in a 53-year-old female. She sustained a hemorrhagic right middle cerebral artery stroke 5 years ago that resulted in finger flexor spasticity and residual weak finger/wrist extension. The patient received 50 units of botulinum toxin type A injections each to the motor points (2 sites each muscle) of left flexor digitorum superficialis and flexor digitorum profundus. Botulinum toxin injections led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks. Improved release time was accompanied by shortened extensor EMG activity. Improvement in release time was possibly related to block co-contraction of finger flexors during voluntary finger extension. This case report demonstrated that Botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

No MeSH data available.


Related in: MedlinePlus