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Feasibility of Adjunct Therapy with a Robotic Hand Orthosis after Botulinum Toxin Injections in Persons with Spasticity: A Pilot Study

Title: Feasibility of Adjunct Therapy with a Robotic Hand Orthosis after Botulinum Toxin Injections in Persons with Spasticity: A Pilot Study
Authors: Ranzani R.; Razzoli M.; Sanson P.; Song J.; Galati S.; Ferrarese C.; Lambercy O.; Kaelin-Lang A.; Gassert R.
Contributors: Ranzani, R; Razzoli, M; Sanson, P; Song, J; Galati, S; Ferrarese, C; Lambercy, O; Kaelin-Lang, A; Gassert, R
Publisher Information: MDPI; CH
Publication Year: 2024
Collection: Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive)
Subject Terms: botulinum toxin; exoskeleton; grasp function; hand; muscle tone; neurorehabilitation; robot-assisted rehabilitation; robotic hand orthosi; spasticity treatment; stroke
Description: Upper-limb spasticity, frequent after central nervous system lesions, is typically treated with botulinum neurotoxin type A (BoNT-A) injections to reduce muscle tone and increase range of motion. However, performing adjunct physical therapy post-BoNT-A can be challenging due to residual weakness or spasticity. This study evaluates the feasibility of hand therapy using a robotic hand orthosis (RELab tenoexo) with a mobile phone application as an adjunct to BoNT-A injections. Five chronic spastic patients participated in a two-session pilot study. Functional (Box and Block Test (BBT), Action Research Arm Test (ARAT)), and muscle tone (Modified Ashworth Scale (MAS)) assessments were conducted to assess functional abilities and impairment, along with usability evaluations. In the first session, subjects received BoNT-A injections, and then they performed a simulated unsupervised therapy session with the RELab tenoexo in a second session a month later. Results showed that BoNT-A reduced muscle tone (from 12.2 to 7.4 MAS points). The addition of RELab tenoexo therapy was safe, led to functional improvements in four subjects (two-cube increase in BBT as well as 2.8 points in grasp and 1.3 points in grip on ARAT). Usability results indicate that, with minor improvements, adjunct RELab tenoexo therapy could enhance therapy doses and, potentially, long-term outcomes.
Document Type: article in journal/newspaper
File Description: ELETTRONICO
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/39195756; info:eu-repo/semantics/altIdentifier/wos/WOS:001304783900001; volume:16; issue:8; journal:TOXINS; https://hdl.handle.net/10281/554765
DOI: 10.3390/toxins16080346
Availability: https://hdl.handle.net/10281/554765; https://doi.org/10.3390/toxins16080346
Rights: info:eu-repo/semantics/openAccess ; license:Creative Commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.7CEA5EE7
Database: BASE