Objective: Analysis of the impact of an individualized comprehensive focal spasticity management on health-related quality of life.
Design: Prospective observational and interventional 12-week trial in a single-centre rehabilitation outpatient clinic.
Patients: Forty-one adult patients with upper motor neurone lesions (23 men), mean age 52 (standard deviation 13) years; 27 stroke, 7 cerebral palsy and 7 miscellaneous diagnoses.
Methods: Patients were assessed using the Short Form 36 (SF-36) Questionnaire before and after intramuscular injections of botulinum toxin type A combined with physical interventions. Spasticity was assessed with the Ashworth Scale (0-4). A verbal scale for patients' self-report of therapy effect was also used.
Results: Significant improvement was found in 3 of 8 SF-36 health scales: social (p = 0.008) and physical functioning (p = 0.026), and role physical (p = 0.048). Spasticity improved significantly (mean 1.1, p < 0.001). Improvement according to the verbal scale was observed for 57 (86%) indications (overall improvement in 36 patients, 88%).
Conclusion: Comprehensive focal spasticity management with botulinum toxin type A intramuscular injections and physical interventions can improve patients' perceived health-related quality of life in addition to objectively and subjectively measured motor functions.