Consequences of neurologic lesions assessed by Barthel Index after Botox® injection may be underestimated

Therapeutics and Clinical Risk Management, 2012 · DOI: http://dx.doi.org/10.2147/TCRM.S32974 · Published: October 18, 2012

Pharmacology Neurology Rehabilitation

Simple Explanation

This study investigates whether the Barthel Index (BI) underestimates the impact of neurological conditions when evaluating the effectiveness of botulinum toxin (Botox) injections. The study found that while Botox injections reduced spasticity, the improvement in functional outcomes as measured by the Barthel Index was not as significant. The authors suggest that clinicians should consider using other measurement scales in addition to the Barthel Index to fully assess the benefits of Botox in rehabilitation after neurologic lesions.

Study Duration

4 years (2008-2011)

Participants

54 patients (35 males, 19 females) with neurologic lesions

Evidence Level

Not specified

Key Findings

1
The Barthel Index score increased in follow-up assessments, but the increase was small and only slightly significant in stroke subjects.
2
No significant correlation was found between the degree of spasticity and the Barthel Index score.
3
Patients with MS required double the dosing in the lower limbs and half the dosing in upper limbs of what the stroke patients required.

Research Summary

The study aimed to investigate whether the Barthel Index (BI) underestimates the consequences of neurologic lesions when assessing the clinical outcome after Botulinum toxin type A (BoNT-A) injection. The results showed a small increase in BI score, significant only in stroke subjects, while the degree of spasticity was significantly reduced. Pain and clonus were also reduced. The authors concluded that Botox injections were not strongly correlated with a significant functional outcome according to the BI, suggesting the need for other measurement scales to assess outcomes.

Practical Implications

Comprehensive Assessment

Clinicians should use multiple assessment tools, not solely the Barthel Index, to evaluate the effectiveness of Botox injections for spasticity.

Individualized Treatment

Botox dosage and injection strategies should be tailored to the individual patient's needs and spasticity patterns.

Quality of Life Measures

Future studies should incorporate quality-of-life measures to determine if reduced spasticity translates to meaningful improvements for patients.

Study Limitations

1
Small sample size
2
Retrospective nature of the study
3
Subjects with different disabilities received different BoNT-A doses and a different number of injections

Your Feedback

Was this summary helpful?

Back to Pharmacology