Title : Use of botulinum toxin in improving mobility in chronic stroke in older adults
Abstract:
Improving mobility after more than one year after stroke using botulinum toxin in older adults. The impact of rehabilitation on post-stroke motor recovery and its dependency on the patient’s chronicity remain unclear. The field has widely accepted the notion of a proportional recovery rule with a “critical window for recovery” within the first 3–6 mo poststroke. This hypothesis justifies the general cessation of physical therapy at chronic stages. However, the limits of this critical window have, so far, been poorly defined. We have in our clinic treated older patients with chronic stroke who have spasticity affecting both upper and lower limb to improve their function, mainly walking.
There is a long-lasting critical period of enhanced neuroplasticity post-stroke that enables improvement in body function and structure even at late chronic stages. This is the first time that such an extended critical period of recovery is reported.
An observation study of 20 adults patients age 56-89 years mean age 67, using botulinum toxin in treating spasticity resulted in improvement in mobility.
15 had right hemispheric stroke, 16/20 were males and average duration of stroke was 4 years and 8 months.
Audience Take Away:
- Mobility can improve in chronic stroke even after one or more years
- Older adults do well if there is botulinum toxin usage with physiotherapy
- Use of toxin late in chronic stroke is justified even after as improvement in function can occur particularly in mobility
