Effect of botulinum toxin type-A on traumatic spinal cord injury spasticity

ABSTRACT

To evaluate the effect of botulinum toxin type A on spasticity in spinal cord injured patients and their functional outcome. Forty spastic patients due to traumatic spinal cord injury were studied. Initial assessment included general and neurological examination, ASIA classification, motor power, spasticity grading and functional assessment at the start, at 3 and 6 months. All patients received conventional physiotherapy rehabilitation on daily basis for 3 months then three times weekly for another 3 months. Thirty patients [group I] received botulinum toxin type A in the spastic muscles, dose according to body weight. Ten patients [group II] did not receive botulinum toxin. There 'was no significant difference between groups I and II as regard ADL on the 3 assessments. FIM was significantly lower in group 2 at 3 and 6 months. Clonus score showed a significant higher score of grade 3 and 4 only at 6 months in group II. Spasm frequency scale showed a significant higher rate of scale 3 and 4 in group II at 3 and 6 months. Global pain scale showed no significant difference between groups I and II at any occasion. Adductor tone scale showed a significant higher rate of scale 3 and 4 in group II at 3 and 6 months. Modified Ashworth scale showed a significant higher rate of scale 3 and 4 in group II at 3 and 6 months. Botulinum toxin has a reducing effect on spasticity in spinal cord injured patients, consequently improving their functional outcome: