Electrical stimulation after botulinum toxin injection: a comparison between two different protocols. Preliminary results

Introduction. Several studies showed that electrical stimulation (ES) of the injected muscles enhances the effectiveness of botulinum toxin tipe A (BTX-A) in the treatment of spasticity. However there is no agreement about the most effective ES protocol.1-3 Aim of this study was to compare the effectiveness of two ES protocols combined with BTX-A in the treatment of spasticity. Materials and methods. 20 patients with spastic arm were evaluated before and 30 days after the BTX-A injection at biceps brachii and abductor digiti minimi (ADM) by means of elbow passive range of movement, Modified Ashworth Scale, Bahktha test and CMAP measured at the ADM. 10 patients (group A) received in the injected muscles a 60 minutes ES immediately after injection. 10 patients (group B) received three daily 30 minutes ES sessions following the injection. Results. A significant improvement in the MAS (A: p=0.003; B: p=0.004) and the ADM CMAP (A: p=0.005; B: p=0.005). No difference was seen at the between group comparison. Conclusion. The present preliminary study was unable to find a difference in terms of effectiveness between the two ES protocols combined with BTX-A injection. Short-term ES seems to be feasible, well tolerate and less expensive.