COMBINATION TREATMENT WITH BOTULINUM TOXIN TYPE A INJECTION AND OCCUPATIONAL THERAPY FOR UPPER LIMB HEMIPARESIS AFTER STROKE: CASE REPORT

We report on case in which both injections of botulinum toxin type A (BoNT-A) and occupational therapy were performed for a patient with spastic upper limb hemiparesis after stroke. A patient were 63-year-old right-handed male, left upper limb hemiparesis due to cerebral hemorrhage. After occupational therapy was performed for 1 month, BoNT-A was fi rst injected and occupational therapy was continued for a further 3 months. Outcome measures were the Brunnstrom Stage, Fugl-Meyer Assessment, the Action Research Arm Test,the Modifi ed Ashworth Scale, and the Jikei Assessment Scale for Motor Impairment in Daily Living. A patient were assessed on 1 month before and just injection, and 1 and 3 months after BoNT-A injection. The combination therapy improved the motor function of the upper limb and increased the frequency of limb use in activities of daily living. The BoNT-A, which was injected after the patient’s motor function and needs were assessed, reduced the spasticity. Through occupational therapy the patient used the paralyzed upper limb consciously with step-by-step training to achieve his needs. (Tokyo Jikeikai Medical Journal 2016;131:41-47) Department of Rehabilitation, The Jikei University Kashiwa Hospital Department of Rehabilitation, The Jikei University School of Medicine COMBINATION TREATMENT WITH BOTULINUM TOXIN TYPE A INJECTION AND OCCUPATIONAL THERAPY FOR UPPER LIMB HEMIPARESIS AFTER STROKE: CASE REPORT 伊 東 寛 史 池ヶ谷 正 人 竹 川 徹 安 保 雅 博 2 A型ボツリヌス毒素の複数回投与と外来作業療法の併用療法により 上肢機能の改善を認めた1症例