Dynamic computerised hand dynamometry: Measuring outcomes following upper limb botulinum toxin-A injections in adults with acquired brain injury
Hannah L. Barden, Ian J. Baguley, Melissa T. Nott, Chrisine Chapparo
Brain Injury Rehabilitation Service, Westmead Hospital, 2145 Wentworthville, Australia
Objectives: Evaluate upper limb performance in adults receiving botulinum toxin-A injections for upper limb spasticity using Dynamic Computerised Hand Dynamometry and current clinical measures.
Design: Pre-test/post-test clinical intervention study.
Subjects/Patients: Twenty-eight participants with spasticity following acquired brain injury.
Methods: Botulinum toxin-A effects were measured 4 weeks post-injection using Dynamic Computerised Dynamometry. Current clinical upper limb performance measures spanning the International Classification of Functioning, Disability and Health domains were also conducted at the Body Function and Structure (Modified Ashworth Scale; Tardieu Scale) and Activity (Action Research Arm Test; Goal Attainment Scaling; patient disability and carer burden scales) domains. Dynamic Computerised Dynamometry hand performance measures were correlated with performance on current clinical measures.
Results: Significant post botulinum toxin-A changes were identified on current clinical measures and the Dynamic Computerised Dynamometry. Dynamic Computerised Dynamometry results correlated with current clinical measures demonstrating functional upper limb change across the Body Function and Structure and Activity domains.
Conclusion: Dynamic Computerised Dynamometry sensitively assesses the effects of botulinum toxin-A on upper limb spasticity during a simple, functionally based, grasp and release task. Unlike current measures, the Dynamic Computerised Dynamometry provides information across the Body Function and Structure and Activity domains of the International Classification of Function.
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