Improved real-world arm use by Hybrid Assistive Neuromuscular Dynamic Stimulation therapy after injection of botulinum toxin type A for subacute stroke with severe upper-extremity spastic paresis:

A case study

Abstract

Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS) therapy has been effective as a treatment for stroke-related hemiplegia. However, the treatment is often difficult for patients with severe upper-extremity spastic paresis. We implemented HANDS therapy after injection of botulinum toxin type A (BTX-A) for subacute stroke with severe upper-extremity spastic paresis. As a result, upper-extremity function and real-world arm use improved. The improvement lasted up to two months after the end of HANDS therapy. Thus, injection of BTX-A in conjunction with HANDS therapy might reduce spasticity in patients with severe upper-extremity spastic paresis.