Archives of physical medicine and rehabilitation · 1999
Neurolysis of the musculocutaneous nerve with alcohol to treat poststroke elbow flexor spasticity.
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Kong K H, Chua K S
Аннотация
OBJECTIVE: To evaluate the effectiveness of alcohol in neurolysis of the musculocutaneous nerve for the treatment of elbow flexor spasticity in individuals with a stroke.
DESIGN: Case series.
SETTING: Outpatient clinic of a tertiary rehabilitation facility.
PARTICIPANTS: Twenty patients with a mean age of 62.8 years and poststroke duration of 12.3 months with elbow flexor spasticity.
INTERVENTION: Musculocutaneous nerve block of the hemiplegic upper extremity with 50% ethyl alcohol.
OUTCOME MEASURES: The severity of spasticity as assessed by the modified Ashworth scale (MAS) score and the elbow passive range of motion (PROM).
RESULTS: The mean baseline MAS score was 3.7 +/- 0.6, and this improved to 1.7 +/- 1.0, 2.0 +/- 0.8, and 2.1 +/- 0.8 at 4 weeks, 3 months, and 6 months postneurolysis, respectively. The elbow PROM was 87.3 degrees +/- 20.2 degrees, 104.3 degrees +/- 20.1 degrees, 103.8 degrees +/- 18.9 degrees, and 101.6 degrees +/- 19.7 degrees, respectively. These improvements were statistically significant (p < .05). Four subjects had concomitant improvement of finger flexor spasticity and another four had relief of shoulder pain. Three subjects developed temporary dysesthetic pain over the lateral forearm.
CONCLUSION: Neurolysis of the musculocutaneous nerve with alcohol provides good relief of elbow flexion spasticity in hemiplegic individuals.
DESIGN: Case series.
SETTING: Outpatient clinic of a tertiary rehabilitation facility.
PARTICIPANTS: Twenty patients with a mean age of 62.8 years and poststroke duration of 12.3 months with elbow flexor spasticity.
INTERVENTION: Musculocutaneous nerve block of the hemiplegic upper extremity with 50% ethyl alcohol.
OUTCOME MEASURES: The severity of spasticity as assessed by the modified Ashworth scale (MAS) score and the elbow passive range of motion (PROM).
RESULTS: The mean baseline MAS score was 3.7 +/- 0.6, and this improved to 1.7 +/- 1.0, 2.0 +/- 0.8, and 2.1 +/- 0.8 at 4 weeks, 3 months, and 6 months postneurolysis, respectively. The elbow PROM was 87.3 degrees +/- 20.2 degrees, 104.3 degrees +/- 20.1 degrees, 103.8 degrees +/- 18.9 degrees, and 101.6 degrees +/- 19.7 degrees, respectively. These improvements were statistically significant (p < .05). Four subjects had concomitant improvement of finger flexor spasticity and another four had relief of shoulder pain. Three subjects developed temporary dysesthetic pain over the lateral forearm.
CONCLUSION: Neurolysis of the musculocutaneous nerve with alcohol provides good relief of elbow flexion spasticity in hemiplegic individuals.