1000 Section - Injection Protocol and Therapeutic Efficacy of Botulinum Toxin Type A in Post-Stroke/ Post-Traumatic Brain Injury Spasticity: A Real-World Study

Stroke and traumatic brain injury (TBI) are leading causes of spasticity, a debilitating condition that severely impairs function and quality of life. While botulinum toxin type A (BoNT-A) injection is a well-established treatment, real-world data on injection protocols and its efficacy across different disease stages remain limited. This study aimed to analyze the real-world application and therapeutic outcomes of BoNT-A injection for post-stroke/ post-TBI spasticity.

Design:

This retrospective real-world study included 31 patients with post-stroke/ post-TBI spasticity who received BoNT-A injections at Shanghai Yangzhi Rehabilitation Hospital. Spasticity was assessed using the Modified Ashworth Scale. Functional outcomes were measured using the Modified Barthel Index, Berg Balance Scale, and Functional Test for the Hemiplegic Upper Extremity-Hong Kong. Assessments were conducted pre-injection and at 1-month follow-up.

Results:

Upper limb flexor muscles and the triceps surae are the most frequently targeted sites. The biceps brachii and gastrocnemius received the highest injection doses in the upper and lower limbs, respectively. Significant reductions in muscle tone were observed in all targeted muscle groups (p< 0.05). Functional assessments demonstrated substantial improvements in activities of daily living, balance and upper extremity function. Subgroup analysis indicated that patients in both the recovery and chronic phases exhibited significant functional improvements after treatment, suggesting that BoNT-A can achieve favorable therapeutic effects across different disease stages.

Conclusion:

This real-world study demonstrates that a tailored BoNT-A injection protocol is effective for reducing spasticity and, importantly, for achieving significant functional gains in both recovery and chronic phases after brain injury.