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KATHYINBROOKLYN
01-18-2007, 09:44 AM
HERE IS A CLINICAL TRIAL I PARTICIPATED IN AFTER MY HMO CUT ME OFF FROM THIS THERAPY. WE FOUND IT ON LINE AND IT WAS CONDUCTED LOCALLY @CLEVELAND CLINIC. FURTHERMORE, I RECEIVED THE BOTOX FREE, AND RECEIVED A $50 STIPEND FOR EACH INJECTION. IN RETURN I HAD TO KEEP A DIARY
KATHY



This article is from the WebMD
Medical News Archive

Botox May Soothe Muscles After a Stroke

Repeated Botox Injections May Improve Muscle Tone and Function

By Jennifer Warner
WebMD Medical News Reviewed By Louise Chang, MD
on Friday, October 28, 2005


Oct. 28, 2005 -- The same Botox used to wipe out wrinkles may also soothe stiff, rigid muscles after a stroke.

A new study shows that repeated Botox injections after a stroke may improve muscle tone and reduce pain in the hands and arms, making it easier for stroke patients to dress themselves and perform other daily activities.

Researchers say up to 30% of stroke patients suffer from disabling muscle tightness, a condition known as muscle spasticity. When muscle spasticity affects the arms and hands, it makes it difficult for stroke patients to dress, wash, or feed themselves, and carry out other normal tasks.

"If it isn't managed effectively, post-stroke spasticity can result in very disabling complications such as contractures, a condition that leaves the muscles and tendons permanently shortened," says researcher Allison Brashear, MD, in a news release. Brashear is a professor and chairwoman of neurology at Wake Forest University Baptist Medical Center.

"Early intervention with effective therapies is absolutely vital to prevent the profound disability that afflicts many stroke patients, and to lessen the emotional and financial toll on caregivers and the health care system as a whole," says Brashear.

Botox for Muscle Spasticity

Previous studies have shown Botox injections reduced short-term muscle spasticity and pain after stroke, but researchers say this is the first study to look at the long-term effects of the treatment.

In the study, presented at the Annual Meeting of the American Association of Physical Medicine and Rehabilitation in Philadelphia, researchers treated 279 stroke patients with muscle spasticity in their arms and hands with up to five Botox injections delivered over the course of a year. Botox was injected at the wrist, thumbs, fingers, and elbows to block overactive nerve impulses that trigger excessive muscle contractions.

The results showed that after six weeks of treatment, muscle tone in the affected areas was improved and the improvement was sustained throughout the study.

Researchers also measured functional disability in four areas at the start of the study (hygiene, dressing, limb posture, and pain) on a four-point scale from "no disability" to "severe disability" and asked participants to identify which area was most important to them.

The study showed that at least 50% of stroke patients experienced a one-point improvement in their targeted area.

"The treatment resulted in sustained and meaningful functional improvement that makes a difference in the daily lives of stroke patients and the people who care for them," says Brashear.

Seven percent of the participants reported side effects of the Botox treatment, including headache, pain in the arm, or a flu-like illness.

Researchers say the results suggest that Botox may provide relief from poststroke spasticity with fewer side effects than currently available oral drugs, which are associated with side effects such as sedation, mental confusion, dizziness, and muscle weakness.

The study was funded by the pharmaceutical company Allergan Inc., which developed Botox (botulinum toxin type A, BoNTA).


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jlennon06
01-18-2007, 09:58 AM
i've received botox shots in my affected calf and associated therapy several times all at no cost to me since it's fully covered by medicare.

Rowland
01-18-2007, 11:57 AM
Jan and Kathy,
How long do the beneficial effects last? ...in terms of months.?
I've always heard the treatments had to be repeated after a few months.

jlennon06
01-18-2007, 12:33 PM
rowland the effects of botox generally last from 3 to 6 months, long enough to facilitate a new level of therapy but not permanently.

KATHYINBROOKLYN
01-18-2007, 01:36 PM
HI ROWLAND,
BOTOX USUALLY WEARS OFF 3-6 MO. LIKE JAN SAID .hOWEVER, I DO FEEL THAT THERE IS A BIT OF RESIDUAL THAT ALLOWS ME TO DO THINGS I COULD NEVER DO. MY HAND WAS LIKE A LOBSTER CLAW BEFORE AND THOUGH IT GETS TIGHT NOW AFTER 4 MONTHS, IT NEVER, NEVER GETS THAT BAD AGAIN.IT DOES ALLOW FOR A DIFFERENT LEVEL OF EXERCISE, LIKE JAN SAID AND MEDICARE DOES PAY FOR IT.
KATHY

KATHYINBROOKLYN
01-18-2007, 01:43 PM
Another Piece Of Info About Botox,
It Is Helpful To Do Stretching Exercises,wax On, Wax Off, As Mango Shade Described Them. It Also Helps If You Can Keep Your Arm Away From Your Body As Much As Possible. At Night When I Go To Bed I Place A Little Stuffed Animal In My Armpit. That Helps Keep The Weight Of My Arm From Pulling On My Shoulder. Men, You Can Use An Airline Pillow Or A Travel Pillow Easily Obtained At Bed Bath And Beyond. Kathy

jlennon06
01-18-2007, 02:04 PM
although my botox shots were to relax my affected leg and foot.
i'd like to expand on kathy's post to say many of us can benefit by wearing resting splints on our affected arms to keep wrists at neutral and elbows and fingers straight.
after recently hearing of several other strokers who are facing tendon release surgery i've decided to go back to wearing my splint more regularly.
9 years post stroke my arm is sttill flacid but i need to ward off contractures.

Rowland
01-18-2007, 06:47 PM
Can botox help this?

jlennon06
01-18-2007, 07:08 PM
rowland,
my physiatrist uses botox shots to relax and facilitate functiong in "clawed" hands.
an evaluation might be in order.

KATHYINBROOKLYN
01-19-2007, 01:11 PM
ROWLAND,
BOTOX COULD GIVE YOU SOME RELIEF. YOUR HAND LOOKS EDEMATOUS. YOU COULD ALSO BENEFIT FROM A SPLINT OR VIGOROUS STRETCHING EXERCISES. MY HAND LOOKED JUST LIKE THAT AND MY LIFELONG FRIENDS WERE AMAZED @ THE IMPROVEMENT IN IT AFTER ONLY ONE TREATMENT.
BOTOX WORKS BY INTERRUPTING THE FORMATION OF AN IMPORTANT ENZYME --ACETYLCHOLINE,WHICH IS RESPONSIBLE FOR ELECTRICAL ACTIVITY IN A MUSCLE.BEFORE, IT'S LIKE A:rolleyes: LIGHT SWITCH THAT IS ALWAYS ON.CONSIDER BOTOX A CIRCUIT BREAKER.
WHEN I PARTICIPATED IN THE STUDY ONE PARAMETER WAS HAND GROOMING. FOR ME I WAS HAPPY TO BE ABLE TP PUT MY HAND BENEATH A SPIGOT OF WATER AND SCRUB, WASH. IT'S SURE HELPFUL WHEN IN THE SHOWER TO BE ABLE TO ASSIST MY RIGHT WITH MY LEFT.
YOU COULD DEFINITELY BENEFIT FROM AN EVALUATION
KATHY

Rowland
01-19-2007, 05:05 PM
Jan and Kathy,
Thank you both. I'll look into getting some botox treatments.

KATHYINBROOKLYN
01-24-2007, 05:59 PM
This Week's Issue Of U.s. News And World Report Features A Good, Comprehensive Article About Botox.rowland, You Should Read This Article.
Kathy

xqzzzzme
01-26-2007, 11:49 PM
Hi Kathy....

thanks for posting that article.

Did you have any residual pain in your hands and arms after your stroke? If so, did the botox help that as well?

I lost the use of my right arm for almost 3 months....still have some limits in 3 of my fingers. But I never had any pain in my hands or arms.

However, I had tremendous stiffness and soreness in my back and both legs the morning after the stroke....which persisted for over a year, gradually getting better (like I had been slammed by something blunt in my back and legs).

Is that type of "soreness" common? (these sorts of questions the docs really don't have an answer for....)

Jane

KATHYINBROOKLYN
01-28-2007, 09:00 PM
It's Hard To Explain The Kind Of Pain I Experience......and Other Strokers Also. Imagine Sitting Down One Morning And Clasping Your Hand Into A Fist As Tight As You Can And Just Holding It, Never Relaxing Your Hand All Day And All Night.it Gets Tighter As The Day Wears On, Somewhat Relieved By Sleep And Aggravated By Severe Cold. Botox Seems To Relieve It So Much I Consider It As Amazing As The Pyramids Because It Is Manmade Or Man Tweaked. I Think It's A Miracle Even Though The Company, Allergen, Doesn't Market It As A Miracle.
Jim Says He Has Observed A Rise In My Self Confidence Since I Began Getting It. It Is Important To Me To Be Able To Do As Much Around Here As Possible And Tend To My Little Indoor Light Garden,carrying Flower Pots Back And Forth,etc.
It Helps Tremendously With Hygiene, Showering And Dressing.i Am Freshly Botoxed As Of 1/23 And I Can See A Drastic Difference Already.
I Will Say My Hand And Arm Are Very Weak But I Don't Have The Pain Like I Had Before. Just For A Frame Of Reference I Can Still Open A Bottle Of Nail Polish That Is Very Tight If I Twist Awhile And Bang It On The Edge Of The Counter And Twist Some More. And Yes, I Do Polish My Nails. I'm Able To Put My Hand Flat On A Table To Get Access To My Nails.