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Wolf, S.L., Winstein, C.J., Miller, J.P., Taub, E., Uswatte, G., Morris, D., et al. (2006) Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: The EXCITE randomized clinical trial. JAMA, 296, 2095-2104. http://dx.doi.org/10.1001/jama.296.17.2095

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• TITLE: Botulinum toxin type-A (BoNTA) and dynamic wrist-hand orthoses versus orthoses alone for the treatment of spastic-paretic upper extremity in chronic stroke patients

  AUTHORS: Sepideh Pooyania, Brenda Semenko

  KEYWORDS: Stroke Rehabilitation; Botulinum Toxin; Orthosis

  JOURNAL NAME: Open Journal of Therapy and Rehabilitation, Vol.2 No.1, February 15, 2014

  ABSTRACT: Purpose: The purpose of this study was to investigate the potential functional improvement of the spastic-paretic upper extremity of individuals with chronic hemiparesis when using a dynamic wrist-hand orthosis with and without concurrent botulinum toxin type-A (BoNTA) injections into the spastic upper extremity muscles. Methods: A three-year retrospective chart review was conducted on all stroke patients referred to out-patient occupational therapy for an upper extremity rehabilitation program, which included use of a dynamic wrist-hand orthosis (DWHO). Three charts documented concurrent treatment with a DWHO + BoNTA. Eleven charts documented DWHO use without concurrent BoNTA treatment. Pre- and post-intervention outcome measure scores were compared between the two groups. Pre- and post-interven- tion scores were also analyzed irrespective of treatment group. Results: Although improvement approached significance on three of the documented outcome measures when comparing the DWHO + BoNTA and DWHO groups, no statistically significant changes were found. A significant difference (p