SBOTE Study: Extracorporeal Shock Wave Therapy Versus Electrical Stimulation After Botulinum Toxin Type A Injection for Post-Stroke Spasticity-A Prospective Randomized Trial
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- 作者：Andrea Santamato&lowast ; ; Angela Notarnicola&dagger ; ; angelanotarnicola@yahoo.it ; Francesco Panza&Dagger ; ; Maurizio Ranieri§ ; ; Maria Francesca Micello&lowast ; ; Paolo Manganotti|| ; Biagio Moretti&dagger ; ; Francesca Fortunato¶ ; ; Serena Filoni# ; Pietro Fiore&lowast ;
- 关键词：Spasticity ; Botulinum toxin type A ; Electrical stimulation ; Extracorporeal shock wave therapy
- 刊名：Ultrasound in Medicine and Biology
- 出版年：2013
- 出版时间：February, 2013
- 年：2013
- 卷：39
- 期：2
- 页码：283-291
- 全文大小：312 K
文摘
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.