7 / 21
Page 25
Notes:
allied
academies
August 14-16, 2017 | Toronto, Canada
BRAIN DISORDERS AND DEMENTIA CARE
4
th
International Conference on
Neurosurg, an open access journal
ISSN: 2471-9633
To evaluate the effectiveness of BOTOX (Botulinum Toxin Type A) in the treatment of focal spasticity
among geriatric stroke survivors
Janusz A. Kaleta
Manhattan Nursing Services PLLC, USA
Relevance:
Spasticity is a common challenge encountered
post stroke by survivors, families as well as therapists,
nurses and other health care professionals get involved in
treatment of stroke survivors. Dependent on the severity,
spasticity can lead to serious debilitating conditions such as
pain, stiffness, rigidity and inability to participate in essential
activities of daily living as well as in therapy. Spasticity
as well as muscular overactivity frequently has profound
impact on lives of stroke survivors. Although conventional
Physical Medicine and Rehabilitation offers interventions
for spasticity management there is a continuous search into
new ways to combat spasticity more effectively and to allow
for greater recovery and independence of stroke survivors.
Stroke is a leading cause for transfers into Long Term Care
Homes. Geriatric stroke survivors are often confronted with
greater severities of post stroke complications including
spasticity and therefore need a proper approach geared
towards that population.
Methods:
Review of evidence on BOTOX (Botulinum Toxin
Type A) clinical application, safety and effectiveness was
conducted. Spasticity program combining evidence based
guidelines for stroke rehabilitation and use of BOTOX was
developed in Long Term Care Home. Twelve geriatric stroke
survivors and one client with diagnosis of cerebral palsy were
assessed by Physiatrist. Client, families and interdisciplinary
team was involved in active collaboration. Based on
comprehensive assessment four stroke survivors received
BOTOX injections in addition to conventional therapy
received from a Physiotherapist and Rehabilitation staff.
All clients were also encouraged to participate in offered
activation therapy that combines movement, self-expression
and discussions. The 4 Point Disability Assessment Scale was
used to assess effectiveness of BOTOX in conjunction with
traditional physiotherapy treatment.
Results:
The spasticity program combining conventional
rehabilitation practices and use of BOTOX demonstrated
marked improvements in ROM, decrease in pain and rigidity,
improved comfort/positioning, ability to participate in
physiotherapy and basic activities of daily living. The results
were measured with use of the 4 Point Disability Assessment
Scale (DAS).
Findings:
Geriatric stroke survivors with focal spasticity
were able to regain greater mobility and functionality
post participation in BOTOX treatment in conjunction with
traditional physiotherapy. Spasticity clinics and or access to
Physiatrist could effectively alleviate disabling impact of this
post stroke condition on Geriatric stroke survivors.
Discussion/Conclusion:
While stroke survivor enters
acute care and spends weeks in rehabilitation setting large
percentage of geriatric stroke survivors spend months, years
or decades within Long Term Care. At such there is a need
to heightened sector awareness for specialty services that
should be available to geriatric stroke survivors.
Speaker Biography
Janusz Kaleta works at Patient's safety and risk management as a specialist at Human
Restauro in New York City, USA
e:
jkaleta@uwo.caJanusz A. Kaleta, Neurosurg 2017, 2:2
DOI: 10.21767/2471-9633-C1-005