Investigating Inducible Muscle Overactivity in Acquired Brain Injury and the Impact of Botulinum Toxin A.
Arch Phys Med Rehabil
; 103(1): 75-82.e1, 2022 01.
Article
em En
| MEDLINE
| ID: mdl-34416250
ABSTRACT
OBJECTIVE:
To investigate the pattern of change in muscle overactivity during repetitive grasp/release using dynamic computerized dynamometry (DCD; objective 1) and the effect of botulinum toxin A (BTX-A; objective 2).DESIGN:
Secondary analysis of an observational cohort study.SETTING:
Hospital outpatient spasticity management service.PARTICIPANTS:
A convenience sample (N=65), comprising adults with upper motor neuron syndrome affecting the arm after acquired brain injury (ABI; n=38) and participants without ABI (n=27).INTERVENTIONS:
After clinical assessment, a subgroup of participants with ABI (n=28) underwent BTX-A injections as part of their spasticity management. MAIN OUTCOMEMEASURES:
Post hoc DCD data processing extracted the values of minimum force generation between 10 sequential contractions. The pattern of change was analyzed.RESULTS:
The ABI injected group exerted greater force at baseline than both other groups (ABI injected=1.04 kg, ABI noninjected=0.74 kg, participants without ABI=0.53 kg; P=.011). After the first contraction, minimum force values increased for all groups and were greatest in the ABI injected group. With subsequent cycles, the group without ABI showed a linear pattern of decreasing force generation, whereas both ABI groups showed a quadratic increasing pattern, which was of greater magnitude in the ABI injected group. After injection, values for the ABI injected group showed a 51% reduction in inducible muscle overactivity (P=.003) to magnitudes similar to those of the ABI noninjected group.CONCLUSIONS:
This study showed that hand relaxation deteriorated during repetitive movements in people with spasticity, a feature hypothesized to adversely influence everyday hand function. After BTX-A injection, the magnitude but not the pattern of this inducible muscle overactivity improved.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Lesões Encefálicas
/
Toxinas Botulínicas Tipo A
/
Espasticidade Muscular
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Phys Med Rehabil
Ano de publicação:
2022
Tipo de documento:
Article