TY - JOUR
T1 - SBOTE study
T2 - Extracorporeal shock wave therapy versus electrical stimulation after botulinum toxin type a injection for post-stroke spasticity-a prospective randomized trial
AU - Santamato, Andrea
AU - Notarnicola, Angela
AU - Panza, Francesco
AU - Ranieri, Maurizio
AU - Micello, Maria Francesca
AU - Manganotti, Paolo
AU - Moretti, Biagio
AU - Fortunato, Francesca
AU - Filoni, Serena
AU - Fiore, Pietro
PY - 2013/2
Y1 - 2013/2
N2 - Research is on-going to identify new methods of biostimulation to increase the effect of botulinum toxin type A (BTX-A) in the treatment of spasticity. The Spasticity treated by Botulinum Toxin and ESWT (SBOTE) study is a prospective, randomized controlled trial assessing the effectiveness of extracorporeal shock wave therapy (ESWT) given immediately after BTX-A injections compared with electrical stimulation (ES) given immediately after BTX-A therapy for the management of focal upper limb spasticity in stroke patients. ES was given for 30 min twice a day for 5 days starting at 5 Hz; ESWT was given once a day for 5 days. At study follow-up, patients treated with BTX-A injections and ESWT showed a statistically greater significance and continuous decrease of spasticity measure (modified Ashworth scale [MAS]: 1.37, 1.75 and 1.58 at 15, 30 and 90 days post-treatment, respectively), of spasms (spasm frequency scale [SFS]: 0.8 and 0.25 at 30 and 90 days post-treatment, respectively) and of pain (visual analogue scale [VAS]: 1.94 and 1.87 at 30 and 90 days, respectively) compared with patients treated with BTX-A injections and ES (MAS: 2.37, 2.18 and 2.18, respectively) (p <0.05) (SFS: 1.5 and 1.06, respectively) (p <0.05) (VAS: 2.44 and 2.69 respectively) (p <0.05). ESWT enhances the effect of BTX-A to a greater extent than ES, probably by modulating rheology of the muscle and neurotransmission at the neuromuscular junction.
AB - Research is on-going to identify new methods of biostimulation to increase the effect of botulinum toxin type A (BTX-A) in the treatment of spasticity. The Spasticity treated by Botulinum Toxin and ESWT (SBOTE) study is a prospective, randomized controlled trial assessing the effectiveness of extracorporeal shock wave therapy (ESWT) given immediately after BTX-A injections compared with electrical stimulation (ES) given immediately after BTX-A therapy for the management of focal upper limb spasticity in stroke patients. ES was given for 30 min twice a day for 5 days starting at 5 Hz; ESWT was given once a day for 5 days. At study follow-up, patients treated with BTX-A injections and ESWT showed a statistically greater significance and continuous decrease of spasticity measure (modified Ashworth scale [MAS]: 1.37, 1.75 and 1.58 at 15, 30 and 90 days post-treatment, respectively), of spasms (spasm frequency scale [SFS]: 0.8 and 0.25 at 30 and 90 days post-treatment, respectively) and of pain (visual analogue scale [VAS]: 1.94 and 1.87 at 30 and 90 days, respectively) compared with patients treated with BTX-A injections and ES (MAS: 2.37, 2.18 and 2.18, respectively) (p <0.05) (SFS: 1.5 and 1.06, respectively) (p <0.05) (VAS: 2.44 and 2.69 respectively) (p <0.05). ESWT enhances the effect of BTX-A to a greater extent than ES, probably by modulating rheology of the muscle and neurotransmission at the neuromuscular junction.
KW - Botulinum toxin type A
KW - Electrical stimulation
KW - Extracorporeal shock wave therapy
KW - Spasticity
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U2 - 10.1016/j.ultrasmedbio.2012.09.019
DO - 10.1016/j.ultrasmedbio.2012.09.019
M3 - Article
C2 - 23245824
AN - SCOPUS:84871795409
VL - 39
SP - 283
EP - 291
JO - Ultrasound in Medicine and Biology
JF - Ultrasound in Medicine and Biology
SN - 0301-5629
IS - 2
ER -