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Reducing early signs of spasticity in sub-acute stroke patients may lead to improvements in arm-hand-function and arm-hand-skill-performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Single-case-experimental-design and meta-analysis. Ten sub-acute stroke patients (Modified-Ashworth-Scale:1\u200a+\u200ato 3) participated. Training: 2x6 weeks, using a well-described arm-hand regime (therapy-as-usual). Botulinum-toxin was administered once within 5 weeks after onset of therapy-as-usual. Measures: Action-Research-Arm-Test, ABILHAND, Fugl-Meyer-Assessment, grip-strength, Motricity-Index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      At group level, after baseline trend correction, adjusting for spontaneous recovery and therapy-as-usual effects, the added-value of botulinum-toxin-A on arm-hand-function and arm-hand-skill-performance was not confirmed. However, non-detrended data revealed significant improvements over time on arm-hand-function and arm-hand-skill-performance level (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.037). Conversely, at individual level, after baseline trend correction, 7\/10 patients improved on arm-hand-function: Fugl-Meyer-Assessment (N\u200a=\u200a4;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.019), grip-strength (N\u200a=\u200a3;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.014), Motricity-Index (N\u200a=\u200a4;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.002), whereas 6\/10 patients improved on arm-hand-skill-performance: Action-Research-Arm-Test (N\u200a=\u200a3;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.042), ABILHAND (N\u200a=\u200a5;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Application of botulinum-toxin-A may have an added-value in a substantial part of sub-acute stroke patients suffering from spasticity early post-stroke and who, at the point of therapy admission, display no dexterity. It may improve their arm-hand performance when combined with a well\u2013 defined therapy-as-usual.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/nre-201622","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T14:58:10Z","timestamp":1617116290000},"page":"321-336","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Added-value of spasticity reduction to improve arm-hand skill performance in sub-acute stroke patients with a moderately to severely affected arm-hand"],"prefix":"10.1177","volume":"48","author":[{"given":"Johan Anton","family":"Franck","sequence":"first","affiliation":[{"name":"Adelante Centre of Expertise in Rehabilitation and Audiology","place":["The Netherlands"]},{"name":"Adelante Rehabilitation Centre","place":["The Netherlands"]},{"name":"Maastricht University","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob Johannes Elise Marie","family":"Smeets","sequence":"additional","affiliation":[{"name":"Maastricht University","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jule","family":"Elmanowski","sequence":"additional","affiliation":[{"name":"Adelante Centre of Expertise in Rehabilitation and Audiology","place":["The Netherlands"]},{"name":"Adelante Rehabilitation Centre","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolien","family":"Renders","sequence":"additional","affiliation":[{"name":"Adelante Rehabilitation Centre","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henk Alexander Maria","family":"Seelen","sequence":"additional","affiliation":[{"name":"Adelante Centre of Expertise in Rehabilitation and Audiology","place":["The Netherlands"]},{"name":"Maastricht University","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,29]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","unstructured":"Andringa A. 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