Effectiveness of ultrasound guided ethanol motor points block in reduction of spasticity and improvement of upper limb function in hemiplegic patients: a randomized controlled study

Authors

  • Sreejith C. Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India
  • Akoijam Joy Singh Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India
  • Longjam Nilachandra Singh Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India
  • Kanti Rajkumari Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India
  • Margaret Chabungbam Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India
  • Chandrakant Pilania Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India
  • Janet Moirangthem Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20203606

Keywords:

Ethanol block, Modified ashworth scale, Motor assessment scale, Spasticity

Abstract

Background: Stroke is the third leading cause of disability in general population commonly causing upper motor neuron syndrome complications like spasticity, which is more common in upper limb. Ethanol injection into spastic muscle is an emerging effective treatment in the spasticity management. Ethanol causes selective destruction of nerve fibers through denaturation of protein.

Methods: A randomized controlled study was conducted for a period of 2 years from March 2018 on sixty-eight hemiplegic patients to assess the effectiveness of ethanol muscle block in reduction of spasticity and improvement in functional ability. The patients were allocated into two groups (Group A and B). Group A received ultrasound guided intramuscular ethanol injection along with range of motion (ROM) exercises and wrist hand orthosis (WHO) and Group B received ROM exercises and WHO. The outcomes were measured by modified ashworth scale (MAS) for spasticity and modified version of motor assessment scale for functional improvement.

Results: Intervention group showed significant improvement in spasticity shown by reduction of MAS of elbow flexors from 3 at baseline to 1.15±0.3 at 12 weeks as compared to control group with 3 at baseline to 1.76±0.5 at 12 weeks (p<0.05). Upper limb function scale of study group improved from 1.5±0.8 to 3.0±0.6 at 12 weeks compared to control group 1.3±0.8 to 2.8±0.6 (p<0.05).

Conclusions: It can thus be concluded that intramuscular injection of ethanol accompanied by wrist hand orthosis have beneficial effect on improvement of spasticity and upper limb function.

Author Biography

Akoijam Joy Singh, Department of Physical Medicine and Rehabilitation, RIMS, Imphal, Manipur, India

Professor & Head of Department
Department of Physical Medicine & Rehabilitation 
RIMS, Imphal

References

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Published

2020-08-25

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Section

Original Research Articles