An early botulinum toxin A treatment in subacute stroke patients may prevent a disabling finger flexor stiffness six months later: a randomized controlled trial

Objective: The study asked whether an early botulinum toxin A (BTX-A) injection in subacute stroke patients may prevent a disabling finger flexor stiffness six months later.Design: Single-blind, randomized pilot study.Setting: Inpatient rehabilitation centre.Subjects: Eighteen stroke patients, interval 4–6 weeks, non-functional arm, Fugl-Meyer arm score (0–66) <20, beginning elevated finger flexor tone, randomly allocated to group A or B.Interventions: In group A patients 150 units BTX-A (Xeomin) injected into the deep and superficial finger (100 units) and wrist flexors (50 units), no injection in group B patients. Comprehensive rehabilitation in both groups.Main measures: Primary variable was the Modified Ashworth Scale score (0–5) of the finger flexors; secondary variables were whole arm muscle tone with REPAS (a summary rating scale for resistance to passive movement), its motor control with the Fugl-Meyer arm score, and a disability scale, blindly assessed at T0 (start), T1 (four weeks) and T6 (six m...