The use of combination therapy in the treatment of lower limb spasticity among patients after stroke - a review of literature

Abstract

Stroke is not only a medical problem, but also, due to the permanent disability of patients, a significant social issue. Therefore, gait disturbances resulting from lower limb muscle spastici-ty are a common subject of research. The ambiguities in the scientific literature have become justification for the creation of this systematic review, the aim of which is to collect and ana-lyse works describing the efficacy of combination therapy - including Botulinum toxin type A injections and physiotherapy following stroke. The following databases were searched: Pub-Med, EBSCO, Springer Link (date of access: 24 Jan. 2019). It was assumed that analysis will include scientific works published in English from 2000 to date (in accordance with search date). For the entry "combination therapy" (Botulinum toxin injections and physiotherapy), the search was conducted using the following keywords: physical therapy, Botulinum toxin type A, Botox A, lower limb, gait, brain, stroke, hemiparesis. Out of all the elaborate articles, 7 concerning combination therapy were ultimately evaluated. Analysis of the collected works indicates the effectiveness of combination therapy in the area of improving structural parame-ters. Some of the works prove that this type of therapy also improves functional indices and leads to increased activity of patients. We could not collect satisfactory evidence confirming its effectiveness in terms of increasing social participation and improving the quality of life of patients. This review indicates the need to develop specific therapeutic protocols accurately describing both Botulinum toxin injections and physiotherapy - taking the intensity, duration and type of therapy into account. Opoka K., Filip M., Mirek E., Pasiut S. The use of combination therapy in the treatment of lower limb spasticity among patients after stroke − a review of literature. Med Rehabil 2019; 23(2): 36-41. DOI: 10.5604/01.3001.0013.0875 This article is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License CC BY-SA (http://creativecommons.org/licenses/by-sa/4.0/) null

Keywords

• stroke
• Botulinum toxin
• physical therapy
• spasticity