TY - JOUR
T1 - Shoulder pain and external rotation in spastic hemiplegia do not improve by injection of botulinum toxin A into the subscapular muscle
AU - De Boer, K. S.
AU - Arwert, H. J.
AU - De Groot, J. H.
AU - Meskers, C. G.M.
AU - Rambaran Mishre, A. D.
AU - Arendzen, J. H.
PY - 2008/5/1
Y1 - 2008/5/1
N2 - Objective: To study the effect of botulinum toxin A in the subscapular muscle on shoulder pain and humerus external rotation. Methods: 22 stroke patients with spastic hemiplegia, substantial shoulder pain and reduced external rotation of the humerus participated in a randomised, double blind, placebo controlled effect study. Injections of either botulinum toxin A (Botox, 2 x 50 units) or placebo were applied to the subscapular muscle at two locations. Pain was scored on a 100 mm vertical Visual Analogue Scale; external rotation was recorded by means of electronic goniometry. Assessments were carried out at 0 (baseline), 6 and 12 weeks. Results: 21 patients completed the study. We observed no significant changes in pain or external rotation as a result of administration of botulinum toxin A. External rotation improved significantly (p = 0.001) for both the treatment group (20.4° (16.6) to 32.1° (14.0)) and the control group (10.3° (19.5) to 23.7° (20.7)) as a function of time. Conclusions: Application of botulinum toxin A into the subscapular muscle for reduction of shoulder pain and improvement of humeral external rotation in spastic hemiplegia does not appear to be clinically efficacious.
AB - Objective: To study the effect of botulinum toxin A in the subscapular muscle on shoulder pain and humerus external rotation. Methods: 22 stroke patients with spastic hemiplegia, substantial shoulder pain and reduced external rotation of the humerus participated in a randomised, double blind, placebo controlled effect study. Injections of either botulinum toxin A (Botox, 2 x 50 units) or placebo were applied to the subscapular muscle at two locations. Pain was scored on a 100 mm vertical Visual Analogue Scale; external rotation was recorded by means of electronic goniometry. Assessments were carried out at 0 (baseline), 6 and 12 weeks. Results: 21 patients completed the study. We observed no significant changes in pain or external rotation as a result of administration of botulinum toxin A. External rotation improved significantly (p = 0.001) for both the treatment group (20.4° (16.6) to 32.1° (14.0)) and the control group (10.3° (19.5) to 23.7° (20.7)) as a function of time. Conclusions: Application of botulinum toxin A into the subscapular muscle for reduction of shoulder pain and improvement of humeral external rotation in spastic hemiplegia does not appear to be clinically efficacious.
UR - http://www.scopus.com/inward/record.url?scp=42449128718&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/jnnp.2007.128371
DO - https://doi.org/10.1136/jnnp.2007.128371
M3 - Article
C2 - 18408090
SN - 0022-3050
VL - 79
SP - 581
EP - 583
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
IS - 5
ER -