Marina Demetrios, Caroline Brand, Julie Louie, Fary Khan
Rehabilitation Medicine Physician, Royal Melbourne Hospital, Royal Park Campus, 34–54 Poplar Road, Parkville 3052, VIC, Australia. E-mail: mdemetrios@hotmail.com, marina.demetrios@mh.org.au
DOI: 10.2340/16501977-2085

Objectives: To describe ambulatory rehabilitation programmes (physical and occupational therapy activities and interventions) following botulinum toxin injections for post-stroke spasticity using a stroke rehabilitation taxonomy. To explore the relationship between therapy provided and injected limb/s and treatment goals.
Design: Prospective, observational cohort study.
Participants: Stroke survivors (n = 47) participating in ambulatory rehabilitation programmes following botulinum toxin injections for upper limb, lower limb or upper and lower limb spasticity.
Methods: Standardized therapy documentation forms were completed prospectively for each occupational and physical therapy session. Main outcomes were the proportion of total therapy time spent in various therapeutic activities; total sessions during which each intervention was used to facilitate the activities most time was spent in; and goals related to each activity category. Sub-analysis was carried out for participants, based on limb/s injected.
Results: Most time was spent in “upper extremity control” activities as the upper limb was more often injected. A large proportion of therapy time was spent in activities remediating “performance skills or body structure and function impairments”. In the upper and lower limb, and upper limb groups 38. 7% and 46. 2% of goals, respectively, related to this activity category, but less than 10% in the lower limb group. Little time was spent in community participation and leisure activities, whilst over one-third of lower limb group goals related to this category.
Conclusion: Ambulatory rehabilitation programmes following botulinum toxin injections for post-stroke spasticity varied depending on limb/s injected and reflected treatment goals to some extent.