Comparison between repetitive peripheral magnetic stimulation [RPMS] and botulinum toxin -A injection in management of spasticity

ABSTRACT

To compare between the use of repetitive peripheral magnetic stimulation and botulinum toxin-A injection in management of spasticity in patients with paraparesis. Twenty three patients suffering from spastic paraparesis due to traumatic spinal cord injury were included in this study. Assessment included spasm frequency scale [SFS], adductor tone scale, Modified Ashworth scale [MMAS], clonus score, Medical research council scale for muscle power testing. Patients were divided into two groups, group A [10 patients] received botulinum toxin type A injection and group B [13 patients] received repetitive peripheral magnetic stimulation [RPMS] one session daily for 3 successive days. All patients were reassessed at 4, 7 and 30 days from the start of therapy. There was no significant difference in the neurological baseline data after 4 and 7 days in group A patients. However, after 30 days, there was a statistically significant decrease in the spasticity scales. After four days therapy, there was highly significant difference [p<0.01] in the neurological scales with decreased spasticity scales in group B compared to group A. After seven days, there was highly significant difference [p<0.01] between group A and B with decreased spasm frequency and clonus score scales in group A. After 30 days, there was a highly significant difference [p<0.01] between group A and B with decreased adductor tone, modified ashworth, spasm frequency scales, clonus and functional independence measure scores in group A. RPMS and botulinum toxin A injection can be used complementary to each other as RPMS has immediate and short term effects on spasticity while botulinum toxin A has delayed and long term effects on muscle tone