Content » Vol 41, Issue 7

Original report

Botulinum toxin A for treatment of upper limb spasticity following stroke: A multi-centre randomized placebo-controlled study of the effects on quality of life and other person-centred outcomes

Paul McCrory, Lynne Turner-Stokes, Ian J. Baguley, Stephen De Graaff, Pesi Katrak, Joseph Sandanam, Leo Davies, Melinda Munns, Andrew Hughes
DOI: 10.2340/16501977-0366


Objective: Botulinum toxin is known to relieve upper limb spasticity, which is a disabling complication of stroke. We examined its effect on quality of life and other person-centred perspectives.
Design: A multi-centre, randomized, double-blind, placebo-controlled study.
Patients: Ninety-six patients were randomized (mean age 59. 5 years) at least 6 months post-stroke. Mean time since stroke was 5. 9 years.
Methods: Patients received either botulinum toxin type A or placebo into the affected distal upper limb muscles on 2 occasions, 12 weeks apart. Assessment was undertaken at baseline, 8, 12, 20 and 24 weeks. The primary outcome measure was the Assessment of Quality of Life scale (AQoL). Secondary outcome assessments included Goal
Attainment Scaling (GAS), pain, mood, global benefit, Modified Ashworth Scale (MAS), disability and carer burden.
Results: The groups did not differ significantly with respect to quality of life, pain, mood, disability or carer burden. However, patients treated with botulinum toxin type A had significantly greater reduction in spasticity (MAS) (p < 0. 001), which translated into higher GAS scores (p < 0. 01) and greater global benefit (p < 0. 01).
Conclusion: Although no change in quality of life was demonstrated using the AQoL, botulinum toxin type A was found to be safe and efficacious in reducing upper limb spasticity and improving the ability to achieve personal goals.

Lay Abstract


Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors. You need to login/create an account to comment on articles. Click here to login/create an account.