Botulinum Toxin for the Upper Limb after XXXX (BoTULS) Trial: effect on impairment, activity limitation, and @entity158 .

@entity1 @entity64 @entity508 @entity3140 @entity158
BACKGROUND AND PURPOSE: Botulinum toxin is increasingly used to treat upper limb @entity508 due to @entity64 , but its impact on arm function is unclear. We evaluated botulinum toxin for upper limb @entity508 and function poststroke. METHODS: Three hundred thirty-three @entity1 with @entity64 with upper limb @entity508 and reduced arm function participated in a multicenter randomized controlled trial. The intervention group received botulinum toxin type A injection(s) plus a 4-week therapy program. The control group received the therapy program alone. Repeat injection(s) and therapy were available at 3, 6, and 9 months. The primary outcome was @entity3140 at 1 month (Action Research Arm Test). Secondary outcomes included measures of impairment, activity limitation, and @entity158 at 1, 3, and 12 months. Outcome assessments were blinded and analysis was by intention to treat. RESULTS: There was no significant difference in achievement of improved arm function (Action Research Arm Test) at 1 month (intervention group: 42 of 167 [25.1%], control group 30 of 154 [19.5%]; P=0.232). Significant differences in favor of the intervention group were seen in muscle tone at 1 month; upper limb strength at 3 months; basic arm functional tasks (hand hygiene, facilitation of dressing) at 1, 3, and 12 months; and @entity158 at 12 months. CONCLUSIONS: Botulinum toxin type A is unlikely to be useful for improving active @entity3140 (eg, reaching and grasping) in the majority of @entity1 with @entity508 after @entity64 , but it may improve basic upper limb tasks (hand hygiene, facilitation of dressing) and @entity158 .
