Evaluation of manual dexterity after treatment with botulinum type A(B), selected kinesitherapeutic methods: a case study
Sebastian Głowiński, Karol Łosiński, Agnieszka Grochulska, Gabriela Płotka, Adam Hałaburda
S. Głowiński, K. Łosiński, A. Grochulska, G. Płotka, A. Hałaburda – Evaluation of manual dexterity after treatment with botulinum type A(B), selected kinesitherapeutic methods: a case study. Fizjoterapia Polska 2020; 20(4); 40-48
Abstract
Introduction. Botulinum treatment involves the reduction of spasticity in patients qualified for this type of treatment. The main aim of this treatment is to increase the quality of life by improving functionality. In some situations, however, objective tests indicate a deterioration of movement parameters, and at the same time the patient reports improved performance of basic self-care activities. In this case, the decision to continue the therapy depends on the patient’s subjective feelings.
Material and methods. The study concerns a 20-year-old patient with right-sided spastic paresis resulting from the surgical treatment of left thalamic haemangioma in 2008. The patient was qualified for botulinum toxin treatment under the NFZ programme in 2019. The above-mentioned therapy was applied in combination with selected methods of neurophysiological rehabilitation. The aim was to maximize the positive effects of the therapy: to improve the range of mobility and reduce associated reactions, with minimal loss of manual activities of the right upper limb. Tests were performed to assess muscle tone according to the Ashworth scale, and precision grip according to the “Guidelines of the National Council of Physiotherapists for Health Services”. Additionally, the range of motion in the hand joints was measured using the vision system. A subjective 10-degree scale was proposed to assess the incidence of associated reactions during everyday activities.
Results. The results obtained indicated discrepancies between the objective results of standard tests and the patient’s subjective evaluation. According to the patient, despite the loss of some of her hard-earned mobility patterns, her quality of life improved.
Conclusion. Botulinum injection combined with physiotherapy slightly increased the range of motion in the hand joints, decreased the associated reactions, and slightly improved manual dexterity.
Introduction. Botulinum treatment involves the reduction of spasticity in patients qualified for this type of treatment. The main aim of this treatment is to increase the quality of life by improving functionality. In some situations, however, objective tests indicate a deterioration of movement parameters, and at the same time the patient reports improved performance of basic self-care activities. In this case, the decision to continue the therapy depends on the patient’s subjective feelings.
Material and methods. The study concerns a 20-year-old patient with right-sided spastic paresis resulting from the surgical treatment of left thalamic haemangioma in 2008. The patient was qualified for botulinum toxin treatment under the NFZ programme in 2019. The above-mentioned therapy was applied in combination with selected methods of neurophysiological rehabilitation. The aim was to maximize the positive effects of the therapy: to improve the range of mobility and reduce associated reactions, with minimal loss of manual activities of the right upper limb. Tests were performed to assess muscle tone according to the Ashworth scale, and precision grip according to the “Guidelines of the National Council of Physiotherapists for Health Services”. Additionally, the range of motion in the hand joints was measured using the vision system. A subjective 10-degree scale was proposed to assess the incidence of associated reactions during everyday activities.
Results. The results obtained indicated discrepancies between the objective results of standard tests and the patient’s subjective evaluation. According to the patient, despite the loss of some of her hard-earned mobility patterns, her quality of life improved.
Conclusion. Botulinum injection combined with physiotherapy slightly increased the range of motion in the hand joints, decreased the associated reactions, and slightly improved manual dexterity.
Key words:
spasticity, rehabilitation, physiotherapy, botulinum
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