Can Incobotulinumtoxin-A Treatment Improve Quality of Life Better Than Conventional Therapy in Spastic Muscle Post-Stroke Patients? Results from a Pilot Study from a Single Center

Abstract

Post-stroke spasticity frequently occurs in patients with stroke, and there is a need for more quality-of-life assessments for different therapies. We evaluated for the first time in Romania the quality of life among patients with post-stroke spasticity, comparing two therapies over a 6-month period: botulinum toxin type A (BOT) with conventional therapy (CON). We also assessed the reduction of spasticity and functionality secondary to the increase in the mobility in upper limbs. This study was based on a prospective, randomized design, including subjects with post-stroke spasticity (N = 34; 34–80 years of age): in the CON arm, patients received therapy against muscle spasticity and physiotherapy, and, in the BOT arm, patients received incobotulinumtoxin-A and additionally conventional treatment, if required. Among 34 treated subjects in the two arms, the quality of life was significantly higher after BOT therapy (p < 0.001), represented by improvement in movement (p < 0.001), usual activities (p = 0.018), and distress (p < 0.001). Improvements in muscle tone (Ashworth Scale) over 6 months of treatment period were greater in the BOT arm (100%) than in the CON arm (11.8%). These preliminary results suggested that incobotulinumtoxin-A increased quality of life by improving movement, daily activities, mental health, and muscle tone more effectively than conventional therapy and could form a basis for future comparator studies.

Management of Upper-Limb Spasticity Using Modern Rehabilitation Techniques versus Botulinum Toxin Injections Following Stroke

“…The quality of life of stroke patients is also affected by the presence of spasticity. Botulinum toxin therapy has a favorable impact on the evolution of and increase in the quality of life of these patients by reducing spasticity [45]. Thus, if we are to talk only about the quality of the patient's life, we must also take into account the fact that 60% of these patients also have a cognitive impairment [46].…”

Real Life Experience with Individualized Doses of Incobotulinumtoxina in Patients with Severe Spasticity Due to Acquired Brain Injury

“…The aim of the treatment with botulinum toxin in these patients is not only to improve their functionality, in many cases, the goal is to improve joint ranges of motion and muscle extensibility to facilitate care, hygiene and even improve limb posture. Moreover, it has been suggested that incobotulinumtoxinA increased quality of life by improving movement, daily activities, mental health, and muscle tone more effectively than conventional therapy 11 .…”

Determinants of Quality of Life after Stroke in Southern Portugal: A Cross Sectional Community-Based Study

“…Improvement of post-stroke QoL demands an integrated view of each patient. Management of specific social or health problems, for instance, spasticity, can have a large impact in multiple domains of QoL [23].…”