{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:17:18Z","timestamp":1787840238222,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5]]},"abstract":"\n Background:<\/jats:title>\n Post-stroke 20%\u201340% of patients develop spasticity which can quadruple total cost of care. This impact can be reduced by affordable treatment options for focal spasticity.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n The primary objective of the study was to compare changes in Passive Range of Movements in patients with focal post-stroke spasticity from pre-treatment to end of 1 month of treatment with anti-spastic agents. The secondary objectives were to measure the changes in Modified Ashworth, and Brunnstrom Recovery Staging during the same period.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n This prospective longitudinal cohort study was conducted in a tertiary level rehabilitation center. One hundred and three adults with post-stroke spasticity participated. The patients received one of the four options: Phenol, Onabotulinum toxin, Bupivacaine and Hyaluronidase. The main outcome measures were the following: Changes in Passive Range of Movement (PRoM), Brunnstrom staging (BRS) and Modified Ashworth Scale (MAS).<\/jats:p>\n <\/jats:sec>\n \n Result:<\/jats:title>\n \n Post intervention testing at 1 month was done. Each agent significantly improved BRS (1.10, 95% CI 0.8\u20131.4,\n P<\/jats:italic>\n = 0.001) and PRoM (32.28, 95% CI 27.66- 36.89,\n P<\/jats:italic>\n = 0.001), while reducing MAS (0.39, 95% CI 0.01\u20130.77,\n P<\/jats:italic>\n = 0.05). In addition, subgroup comparisons were done with phenol as a reference for all three outcome measures. There was a significant difference in the improvement of Brunnstrom staging for Bupivacaine (0.52, 0.094\u20130.95, 0.02) compared to phenol. Similarly, Hyaluronidase showed better improvement in MAS (0.39, 0.01\u20130.77, 0.05) compared to Phenol.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n There was a significant difference in PRoM, MAS and Brunnstrom staging from baseline to end of 1 month long anti-spasticity treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0028-3886.349636","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T03:55:57Z","timestamp":1692849357000},"page":"913-917","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["A Comparison of Treatment Options in Focal Post-Stroke Spasticity of the Upper Extremity"],"prefix":"10.4103","volume":"70","author":[{"given":"Ravi","family":"Sankaran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"Raj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-14-20241013","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/S1474-4422(16)30073-4","article-title":"Global Burden of Diseases, Injuries and Risk Factors Study 2013 and Stroke Experts Writing Group. Global burden of stroke and risk factors in 188 countries, during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"15","author":"Feigin","year":"2016","journal-title":"Lancet Neurol"},{"key":"R3-14-20241013","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1161\/STROKEAHA.110.581991","article-title":"Occurrence and clinical predictors of spasticity after ischemic stroke","volume":"41","author":"Urban","year":"2010","journal-title":"Stroke"},{"key":"R4-14-20241013","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1161\/STROKEAHA.109.558619","article-title":"Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: The first year after the event","volume":"41","author":"Lundstr\u00f6m","year":"2010","journal-title":"Stroke"},{"key":"R5-14-20241013","first-page":"660","article-title":"Interrater reliability of the NIH stroke 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