The Systematic Review Of The Botulinum Toxin Type A Treatment Of Upper Limb Spasticity After Stroke

Objective:To evaluate the therapeutic effects of Botulinum Toxin Type A on upper limb spasticity after stroke. Authenticatethe use of BTX-A related to ability to restore activity and properties of upper limb after stroke. Methods:From2004to2013January computer retrieval during PubMed, China Academic Journal Full-text Database (CNKI), China Wanfang medicine literature database, Cochrane, Ovid Central Register of con-trolled trials. Retrieval languages is not limited. Included simple rehabilitation treatment and rehabilitation treatment combined with Botulinum Toxin that two schemes for stroke in upper limb spasticity and comparing with randomized controlled trials, and observation of Ashworth classification of stroke patients after treatment by two ways of Modified Ashworthscale, Fugl-Meyer Assessment Scale, Functional Independence Measure, Barthel Index. Data related to clinical outcomes were extracted by two reviewers independently. Meta analysis was performed by RevMan5.2software. Result:Included in the study were7ran-domized controlled trial in317patients. Meta analysis showed that:Simple rehabilita-tion treatment group and rehabilitation combined with BTX-A treatment group curative effect comparison, two in FMA[MD=-9.13,95%CI(-12.59,-5.67), P<0.00001], MAS[MD=0.66,95%CI(0.38,0.94), P<0.00001], Barthel index[OR=-15.01,95%CI(-23.84,-6.17), P<0.0009],FIM[MD=-2.53,95%CI(-4.77,0.08), P=0.06], the differences were statistically significant. Conclusion:Rehabilitation combined with BTX-A simple rehabilitation in12weeks after the treatment, Modified Ashworth scale, Fugl-Meyer assessment scale, Functional Independence Measure, Barthel index shows a better therapeutic effect, the use of BTX-A related to ability to restore activity and properties of upper limb after stroke, rehabilitation therapy combined with BTX-A treatment is a more reasonable way of therapy.