Stroke survivors to benefit from Botox

Botox is now available on the Pharmaceutical Benefits Scheme (PBS) for treating upper limb spasticity (muscle tightness) in patients who have suffered a stroke. 

Associate Professor John Olver, medical director of Rehabilitation for Epworth Medical Group, welcomed the PBS indication, noting that stroke is the leading cause of long-term disability in Australia.

Almost half of all stroke survivors will endure some form of muscle tightness (spasticity), much of which can be improved with rehabilitative therapy.

“Many post-stroke patients with upper limb spasticity have muscle tightness which limits movement in their shoulders, elbows, wrists and fingers. This tightness reduces their ability to go about day-to-day activities, such as dressing, eating and writing. 

“Improving the ease of use of their muscles by reducing this tightness is a priority treatment goal for many patients,” he said.

National Stroke Foundation medical director, Professor Christopher Bladin, said that the National Stroke Foundation’s clinical guidelines for stroke rehabilitation and recovery recommends the use of intervention such as Botox for people with moderate to severe spasticity.
 
“As stroke survivors face many challenges after stroke it is important that rehabilitation treatments are easily accessible,” he said.

Although often critical to regaining movement and independence, rehabilitative treatment can be limited if treating professionals are unable to manipulate the contracted muscles. Botox treatment works by helping to relax contracted muscles, assisting with treatments such as physiotherapy, and also helping to maintain hygiene (e.g. cleaning a clenched hand).

It is available on the PBS in combination with physical therapy, or after standard treatment has failed. Clinical studies show that Botox can effectively reduce spasticity symptoms and improve the ability of stroke survivors to undertake day-to-day activities that would otherwise require caregiver assistance.

In a study where Botox treatment was used over a one year period, patients experienced a significant decrease in symptoms and improved quality of life, compared to their condition before treatment.

The benefits of Botox in post-stroke muscle tightness (spasticity) can last for up to three to four months. Improvements such as decreased muscle tone (i.e. muscle tension) and maintaining hygiene may last longer as Botox treatment can facilitate other treatments such as regular exercise, stretching and splint use.

Associate Professor Olver noted that most post-stroke impairment can be improved and early rehabilitation is a key factor in improving results for stroke patients. Without proper management of muscle tightness, stroke survivors can go on to suffer from contractures (loss of joint motion), painful pressure sores and social isolation.

“Early and ongoing rehabilitation therapy for upper limb spasticity can help relieve painful symptoms, and is also important to prevent further complications, such as contractures of the joints,” he said.