Clinical Study Of Botulinum Toxin Type A Combined With Massage Rehabilitation In Improving Upper Limb Spasm In Stroke Patients

Objective:Taking stroke patients with upper extremity spasm as subjects,we explored the effect of BTX-A on upper limb spasm after stroke,and clarified the correlation between the treatment of BTX-A and the recovery of mobility and function of upper limb spasticity after stroke.Methods:Sixty stroke patients who met the inclusion criteria were divided into a treatment group(30 cases)and a control group(30 cases).The treatment group was given BTX-A injection combined with rehabilitation training,while the control group was given only rehabilitation training.Each rehabilitation training treatment is 30 minutes,once a day,5 times a week,for a total of 12 weeks of treatment.Based on rehabilitation training,the treatment group received an intramuscular injection of BTX-A on the spastic limbs on the first day of treatment.The injection point was selected according to the size of the muscle.Each site was injected with 25-50U,with 1 to 5 muscles per injection.The total injection dose is less than 400U.The two groups of patients were evaluated before and after treatment,with motor function status scale(MSS),international functional disability and health classification(ICF),transcranial magnetic motor evoked potential(MEP),central motor conduction time(CMCT as evaluation indicators.Observe the changes of various indexes before treatment,4th,8th,and 12th week after treatment.Results:After 4 weeks,8 weeks,and 12 weeks of treatment,the MSS score of the treatment group and the control group was significantly higher than before treatment,and the quantified ICF value of two groups was significantly lower than before treatment.The latency of MEP and central motor conduction time of two groups were significantly shorter than before treatment.The difference was statistically significant(p<0.01).The results of the comparison between the treatment group and the control group showed that after 4 weeks of treatment,the MSS score of the treatment group was significantly higher than that of the control group(p<0.05),the latency of MEP and the central motor conduction time were significantly shorter than that of the control group(p<0.05)There is no significant difference between the quantified value of ICF and the control group(P>0.05)。After 8 weeks and 12 weeks of treatment,the MSS score of the treatment group was significantly higher than that of the control group(p<0.05),the quantified ICF value was significantly lower than that of the control group(p<0.01),the latency of MEP and central motor conduction time were significantly higher than that of the control group Shorten(p<0.01).Conclusion:(1)The curative effect of BTX-A intramuscular injection combined with rehabilitation training is better than rehabilitation training alone in patients with upper limb spasm after stroke.(2)Injection of BTX-A can promote the functional recovery of patients with upper limb spasm by changing the excitability of the cerebral cortex of patients.(3)Injection of BTX-A can significantly improve the clinical efficacy of rehabilitation therapy for patients with upper limb spasm after stroke,and help to quickly restore the patient’s life activity ability and limb motor function.