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Original Research Article | OPEN ACCESS

Effect of combination of botulinum toxin and electromyographic biofeedback therapy on post-stroke patients with lower limb muscle spasticity

Honglin Wang1, Xueming Wang2, Changsheng Yu3

1Department of Rehabilitation Medicine, Shanghai Seventh People’s Hospital, Shanghai 200137, China; 2Department of rehabilitation, Linyi Hospital of traditional Chinese Medicine, Linyi, China; 3Elderly Service Center, Shandong Electric Power Hospital, Jinan, 250002, Shandong Province, China.

For correspondence:-  Changsheng Yu   Email: chenlin2454115004@163.com

Accepted: 25 August 2022        Published: 30 September 2022

Citation: Wang H, Wang X, Yu C. Effect of combination of botulinum toxin and electromyographic biofeedback therapy on post-stroke patients with lower limb muscle spasticity. Trop J Pharm Res 2022; 21(9):2001-2007 doi: 10.4314/tjpr.v21i9.26

© 2022 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To investigate the clinical effect of combined use of botulinum toxin type A and electromyographic biofeedback therapy (EMGBFT) on post-stroke patients with lower limb muscle spasticity.
Methods: The data of 91 post-stroke patients with lower limb muscle spasticity who were admitted to Shanghai Seventh People’s Hospital (January 2020 -January 2021) were retrospectively analyzed, and they were divided into control group (COG, n = 45) and study group (STG, n = 46) based on the treatments given. All patients received conventional rehabilitation and training. Patients in COG were treated with EMGBFT, whereas those in STG received botulinum toxin type A as well as EMGBFT. The parameters determined in the two groups were degree of spasticity, lower limb motor function [3m-Timed Up and Go (3m - TUG) and 10m - Walk Test (10 m - WT)], active range of motion (AROM) of ankle dorsiflexion, ability of daily living (based on Barthel Index, BI), and adverse reactions before and after treatment. 
Results: The effectiveness of the treatments on spasticity was higher in STG than in COG (p < 0.05). After treatment, the times taken for 3m-TUG and 10m-WT were significantly shorter in STG than in COG (p < 0.05). The AROM of patients in both groups was expanded, but the expansion was significantly greater in STG than in COG (p < 0.05).
Conclusion: Combined therapy using botulinum toxin and EMGBFT effectively relieved lower limb muscle spasticity of post-stroke patients, and also improved their lower limb motion function and daily living ability. Thus, the combined therapy provided better management of lower limb spasticity. However, further clinical trials are required prior to its adoption in clinical practice.

Keywords: Stroke, Lower limb muscle spasticity, Botulinum toxin, Electromyographic biofeedback therapy (EMGBFT)

Impact Factor
Thompson Reuters (ISI): 0.523 (2021)
H-5 index (Google Scholar): 39 (2021)

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