Original articleMeasuring Spasticity and Fine Motor Control (Pinch) Change in the Hand After Botulinum Toxin-A Injection Using Dynamic Computerized Hand Dynamometry
Section snippets
Methods
This open-label, pretest/posttest study was approved by the local Institution Human Research Ethics Committee. Participants provided written informed consent before study involvement.
Results
Participants were 28 adults (mean age, 51 years; 13 women) with the UMN syndrome after ABI (22 stroke, 6 traumatic brain injury) a mean of 7.5 years postevent. At the time of assessment, there were 25 right-hand dominant and 3 left-hand dominant participants, with 12 participants changing hand dominance after ABI (17 right-hand dominant, 11 left-hand dominant postevent). Participants were injected with either Dysportd (n=15; mean dose=740Units; dose range, 500–1200Units) or Botoxe (n=13; dose
Discussion
This open-label prestudy/poststudy evaluated change in hand performance after upper limb BTX-A injections in people with chronic ABI using DCD(pinch), a novel task-based procedure for measuring pinch and release,23 and correlated these changes against existing clinical measures.
In line with preexisting research, this study did not demonstrate group-level improvement in the fine motor function of the hand using a standardized hand function measure (ARAT), whether or not participants had active
Conclusions
DCD(pinch) is an objective measure of fine motor hand performance undertaken during a simulated pinch and release task. Current literature recommends upper limb spasticity to be measured across the Body Function and Structure, Activity, and Participation domains of the ICF. However, research to date has had difficulty demonstrating Activity and Participation domain changes in hand performance after BTX-A injection. This study suggests that after a certain minimum force can be generated,
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Biometrics Ltd, Units 25-26, Nine Mile Point Ind Est, Cwmfelinfach, Gwent NP11 7 HZ, UK.
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ADInstruments Pty Ltd, Unit 13, 22 Lexington Dr, Bella Vista, NSW 2153, Australia.
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IBM SPSS, 233 S Wacker Dr, 11th Fl, Chicago, IL 60606.
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Ipsen Pty Ltd, Level 2, Building 4, Brandon Office Park, 540 Springvale Rd, Glen Waverley, Victoria 3150.
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ALLERGAN AUSTRALIA PTY LTD, ABN 85 000 612 831, 810 Pacific Highway, Gordon NSW, 2072 Australia.
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This article is derived from data collected as part of an investigator-initiated study supported by Ipsen Australia.
Barden's PhD candidature is supported by an Australian Postgraduate Award, The George Burniston Cumberland Foundation Fellowship 2011, and the Helga Pettitt Faculty of Health Sciences Postgraduate Study Award 2011.
Honoraria received from Ipsen and Allergan (Barden, Baguley, and Nott). Advisory board membership for Ipsen (Baguley, Nott, and Barden) and Allergan (Baguley and Nott).