Skip Navigation LinksHome > January 2003 - Volume 82 - Issue 1 > Modified Constraint-Induced Therapy and Botulinum Toxin A: A...
American Journal of Physical Medicine & Rehabilitation:
Case Report: Hemiplegia

Modified Constraint-Induced Therapy and Botulinum Toxin A: A Promising Combination

Page, Stephen J. PhD; Elovic, Elie MD; Levine, Peter BA, PTA; Sisto, Sue Ann PT, PhD

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Page SJ, Elovic E, Levine P, Sisto SA: Modified constraint-induced therapy and botulinum toxin A: A promising combination. Am J Phys Med Rehabil 2003;82:76–80.

Modified constraint-induced therapy and chemodenervation with botulinum toxin A are each efficacious in managing stroke-induced motor disorders; however, the application of these two promising modalities in combination is yet to be examined. This case study describes a 44-yr-old man who experienced a right middle cerebral artery infarct 14 mo before participating in modified constraint-induced therapy. After modified constraint-induced therapy completion, the patient exhibited substantial improvement in affected upper limb use and function but retained difficulty with finger extension secondary to hypertonicity and spasticity in the forearm flexor muscles. Selective chemodenervation of these muscles with botulinum toxin A greatly improved the patient’s self-reported hand function and his scores using objective measures. The authors of this paper present this case to raise the idea of increasing treatment efficacy by combining these two modalities.

© 2003 Lippincott Williams & Wilkins, Inc.


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