Effects of Botox Combined with IVES Treatment on Higher Brain Dysfunction and Motor Paralysis of a Chronic Stroke Patient: A Case Study

[Purpose] We investigated the effect of combined botulinum toxin injections (BoNT-A) and integrated volitional control electrical stimulation (IVES) in a chronic stroke patient. [Patient and Methods] The patient, a 70-year-old man living at home and receiving care support, was diagnosed as having ri...

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Veröffentlicht in:Rigaku ryoho kagaku 2021, Vol.36(3), pp.467-472
Hauptverfasser: ONUMA, Ryo, SOUTOME, Yuki, KIMURA, Mizue, MATSUDA, Tadamitsu, NELSON, Sachiko
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Sprache:jpn
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Zusammenfassung:[Purpose] We investigated the effect of combined botulinum toxin injections (BoNT-A) and integrated volitional control electrical stimulation (IVES) in a chronic stroke patient. [Patient and Methods] The patient, a 70-year-old man living at home and receiving care support, was diagnosed as having right thalamic hemorrhage (left hemiplegia and higher brain dysfunction). He was discharged to home and was confined to a wheelchair with family assistance. After BoNT-A, he received IVES in addition to the usual physical therapy. Before and after BoNT-A, and at 1 week, 1 month, and 2 months, evaluations using the Brunnstrom stage (Brs), range of motion test (ROMt), Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), Line cancellation and bisection test, and Catherine Bergego Scale (CBS) were performed. In addition, a physical therapist evaluated the patient’s reach and transfer movement, and examined change over time. [Results] Improvements in ROMt, MAS, and FMA were seen after the BoNT-A injection. The patient’s performance in the line representational bisection task and CBS also improved. For transfer movement, he became capable of transfer by grasping a handrail with both hands. [Conclusion] Combined therapy of BoNT-A and IVES improved the patient’s long-term active function of the upper limbs, increasing his ability to use his left hand, and his symptoms of unilateral spatial neglect.
ISSN:1341-1667
2434-2807
DOI:10.1589/rika.36.467