The Effectiveness of Spasticity-correcting Upper Limb Surgery Versus Botulinum Toxin Injections in Patients With Upper Limb Spasticity: an Experimental Study With Paired Design

What this Trial Is About

Researchers are evaluating treatments for upper limb spasticity, a common complication after central nervous system injuries such as stroke, traumatic brain injury, or spinal cord injury. This condition can severely limit hand function and daily activities. The study compares the effects of spasticity-correcting surgery and Botulinum toxin (BoNT) injections to determine which treatment is more effective in improving body function, activity, and participation. The research uses an open-label, non-randomized, paired design involving 30 patients. Participants will first receive BoNT injections targeting spastic muscles in the upper limb. The dosage and number of muscles treated depend on the severity of spasticity and are determined by specialists. After at least three months to avoid carryover effects, participants will undergo spasticity-correcting tendon lengthening surgery. The surgical procedure involves lengthening affected tendons to restore muscle length and function, followed by a rehabilitation program including splinting and exercises. Both treatments follow routine clinical care protocols. Throughout the study, patients will be evaluated at multiple time points before and after each treatment. Assessments include the Modified Ashworth Scale to measure spasticity severity and various tests to evaluate hand function, range of motion, strength, activity level, and quality of life. Researchers will analyze changes in these measures to compare the treatments. The study aims to guide future treatment decisions and improve care for patients with upper limb spasticity over a total participation period that spans before and after both interventions.

Comparing Upper Limb Surgery and Botulinum Toxin for Spasticity: A Paired Design Study