Impact of Botulinum Toxin Along with Task-Specific Training in Post-Stroke Quality of Life in Focal Hand Dystonia

Abstract

Objective: To investigate the impact of BOTOX, along with task-specific training, on focal hand dystonia in post-stroke patients and to determine the correlation between quality of life and motor outcomes in upper extremity dystonic patients.

Methodology: A quasi-experimental involving 20 patients, study was conducted at Holy Family Hospital (HFH), Chambeli Institute of Rehabilitation in Rawalpindi, and Neurocounsel Clinic in Islamabad. A convenient sampling technique was utilized to select participants for inclusion in the study. Assessments were conducted at four time points: baseline (0 weeks), 4 weeks, 8 weeks, and 12 weeks. The assessment tools used were the Abductor Digiti Minimi Abduction (ADDA) test, Modified Ashworth Scale (MAS), and Stroke-Specific Quality of Life (SS-QoL) questionnaire. Repeated measures ANOVA was employed to analyze mean differences in data across various weeks. The associations between scales were evaluated using Spearman's rho and Pearson correlation coefficients, based on different variables.

Results: The mean age was 42.7 ± 10.45 years. The study included 14 males and 6 females. Repeated measures ANOVA indicated a significant difference between MAS scores for upper extremity and quality of life in post-stroke dystonic patients, with a p-value of 0.001**. A strong positive correlation coefficient was found between MAS and SS-QoL through Spearman's correlation analysis, with a p-value of less than 0.05.

Conclusion: The administration of Type a Botulinum toxin, coupled with task-specific training, not only exhibited improvements in upper limb motor outcomes but also in the quality of life of focal hand dystonic patients after a stroke.