Academic Journal
Home-based modified constraint-induced movement therapy improves distal motor outcomes after botulinum toxin A injection in chronic stroke.
| Τίτλος: | Home-based modified constraint-induced movement therapy improves distal motor outcomes after botulinum toxin A injection in chronic stroke. |
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| Συγγραφείς: | Zhang W; Department of Neurological Rehabilitation I, Xi'an International Medical Center Hospital, Xi'an, Shaanxi, China., Mei S; Department of Neurological Rehabilitation I, Xi'an International Medical Center Hospital, Xi'an, Shaanxi, China., Wen M; Department of Neurological Rehabilitation I, Xi'an International Medical Center Hospital, Xi'an, Shaanxi, China., Jiao K; Department of Neurological Rehabilitation I, Xi'an International Medical Center Hospital, Xi'an, Shaanxi, China., Zhao L; Department of Neurological Rehabilitation I, Xi'an International Medical Center Hospital, Xi'an, Shaanxi, China., Zhang R; Department of Neurological Rehabilitation I, Xi'an International Medical Center Hospital, Xi'an, Shaanxi, China. |
| Πηγή: | Frontiers in neurology [Front Neurol] 2026 Sep 07; Vol. 17, pp. 1906566. Date of Electronic Publication: 2026 Sep 07 (Print Publication: 2026). |
| Τύπος έκδοσης: | Clinical Trial; Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Frontiers Research Foundation Country of Publication: Switzerland NLM ID: 101546899 Publication Model: eCollection Cited Medium: Internet ISSN: 1664-2295 (Electronic) Linking ISSN: 16642295 NLM ISO Abbreviation: Front Neurol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Lausanne : Frontiers Research Foundation, 2010]- |
| Ιατρικοί όροι (MeSH): | Botulinum Toxins, Type A*/administration & dosage , Botulinum Toxins, Type A*/therapeutic use , Constraint Induced Movement Therapy*/methods , Muscle Spasticity*/etiology , Muscle Spasticity*/drug therapy , Muscle Spasticity*/rehabilitation , Neuromuscular Agents*/administration & dosage , Neuromuscular Agents*/therapeutic use , Stroke*/complications , Stroke*/therapy , Stroke*/drug therapy , Stroke*/physiopathology , Stroke Rehabilitation*/methods, Chronic Disease/drug therapy ; Chronic Disease/rehabilitation ; Chronic Disease/therapy ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome |
| Περίληψη: | Background: Botulinum toxin type A (BoNT-A) effectively reduces focal spasticity. However, this pharmacological effect often fails to translate into consistent functional gains when patients receive conventional rehabilitation after injection. Methods: Clinical data from 102 patients with chronic stroke and finger flexor spasticity who received ultrasound-guided BoNT-A injections were retrospectively analyzed in a single-center cohort study. Patients were categorized into home-based modified constraint-induced movement therapy (h-mCIMT) or dose-matched conventional home-based occupational therapy (h-COT) according to post-injection rehabilitation strategies documented in clinical records. In routine clinical practice, rehabilitation was initiated around day 3 after injection and performed 5 days per week for 4 weeks. Clinical outcomes, including distal FMA-UE, ARAT, MAL, and MAS, were extracted from routine assessments at baseline and follow-up visits. Results: Of the 102 eligible patients, 98 had complete follow-up outcome records and were included in final analysis. Both cohorts exhibited comparable reductions in spasticity, suggesting similar pharmacological effects of BoNT-A. Compared with the h-COT cohort, the h-mCIMT cohort achieved significantly greater distal motor recovery at 4 weeks and 3 months, indicating superior functional hand performance. This was further reflected in greater real-world use of the affected limb, with significantly higher MAL scores at both follow-up assessments. Conclusion: Home-based modified constraint-induced movement therapy following BoNT-A injection provides a feasible and effective strategy to enhance distal motor recovery and real-world upper-limb use in chronic stroke. This combined intervention underscores the importance of structured, task-oriented rehabilitation during the post-injection therapeutic window as a key mechanism for maximizing functional recovery. (Copyright © 2026 Zhang, Mei, Wen, Jiao, Zhao and Zhang.) |
| Competing Interests: | The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
| References: | Brain Neurorehabil. 2024 Nov 21;17(3):e19. (PMID: 39649717) Front Neurol. 2024 Feb 14;15:1282685. (PMID: 38419695) Toxins (Basel). 2024 Apr 09;16(4):. (PMID: 38668609) Front Neurol. 2024 Apr 08;15:1335365. (PMID: 38651107) Phys Ther. 1987 Feb;67(2):206-7. (PMID: 3809245) Phys Med Rehabil Clin N Am. 2024 May;35(2):235-257. (PMID: 38514216) NeuroRehabilitation. 2024 Dec;55(4):399-416. (PMID: 42543864) Front Hum Neurosci. 2022 Dec 05;16:987061. (PMID: 36545351) J Rehabil Med. 2021 Jan 1;53(1):jrm00133. (PMID: 33206198) J Clin Med. 2023 Mar 15;12(6):. (PMID: 36983266) Am J Phys Med Rehabil. 2023 May 1;102(5):409-418. (PMID: 36170751) Clin Neurophysiol. 2021 Jan;132(1):56-62. (PMID: 33248434) Circulation. 2022 Feb 22;145(8):e153-e639. (PMID: 35078371) BMJ Open. 2025 May 30;15(5):e094309. (PMID: 40447439) J Neural Transm (Vienna). 2021 Mar;128(3):321-335. (PMID: 33635442) Lancet Neurol. 2021 Oct;20(10):795-820. (PMID: 34487721) J Rehabil Med. 2021 Feb 24;53(2):jrm00157. (PMID: 33616192) J Am Geriatr Soc. 2003 Oct;51(10):1451-4. (PMID: 14511167) Ann Med. 2025 Dec;57(1):2521427. (PMID: 40551535) Front Behav Neurosci. 2022 Jun 21;16:828599. (PMID: 35801093) J Physiother. 2023 Oct;69(4):249-259. (PMID: 37690958) Brain Commun. 2022 Jan 13;4(1):fcac003. (PMID: 35169708) Top Stroke Rehabil. 2022 Oct;29(7):507-515. (PMID: 34425065) |
| Contributed Indexing: | Keywords: Botulinum toxin type A; chronic stroke; finger flexor spasticity; home-based modified constraint-induced movement therapy; upper-limb rehabilitation |
| Substance Nomenclature: | EC 3.4.24.69 (Botulinum Toxins, Type A) 0 (Neuromuscular Agents) |
| Entry Date(s): | Date Created: 20260922 Date Completed: 20260922 Latest Revision: 20260924 |
| Update Code: | 20260925 |
| PubMed Central ID: | PMC13590366 |
| DOI: | 10.3389/fneur.2026.1906566 |
| PMID: | 42769209 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1664-2295 |
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| DOI: | 10.3389/fneur.2026.1906566 |