A single group, pretest-posttest clinical trial for the effects of botulinum toxin injection using dual guidance into the upper extremity muscles for the treatment of focal spasticity in patients with chronic stroke

Objective: This study aimed to determine if ultrasonography and electrical muscle stimulation-guided botulinum toxin injection into the upper extremity muscles increases the efficacy of the treatment of focal spasticity in patients with chronic stroke. Materials and Methods: This study included 22 chronic hemiplegic stroke patients with grade 2 and 3 spasticity in the upper extremity muscles, based on the Modified Ashworth Scale. The study hypothesis was that ultrasonography and electrical muscle stimulation-guided botulinum toxin injection would increase the efficacy of the treatment of spasticity. The Modified Ashworth Scale, Tardieu Scale, Barthel Index and Fugl-Meyer Motor Assessment Scale were administered at baseline, and at 2 weeks and 2 months post treatment. Results: All parameters were improved significantly at 2 weeks post treatment, as compared to baseline, and the observed improvement persisted at 2 months post treatment (P < 0.05). Conclusion: Ultrasonography and electrical muscle stimulation-guided botulinum toxin injection significantly improved spasticity and functional recovery in chronic stroke patients with upper extremity spasticity.