THE IMPACT OF NEUROFEEDBACK AND BOTULINUM TOXIN TREATMENT ON CLINICAL EFFICACY IN POST-STROKE SPASTICITY

Abstract

The article studies the impact of a three-week integrated therapy program optimized with neurofeedback and botulinum toxin treatment on the severity of spastic paresis of the upper extremity in the early stages of ischemic stroke recovery. The patients (100 p.) were divided into 4 groups: 1^st - botulinum toxin treatment in combination with training on the BOSLAB hardware and software suite, massage, and electrical stimulation of the extensor muscles; 2^nd - botulinum toxin treatment with massage and electrical stimulation of the extensors; 3^rd - only botulinum toxin treatment; 4^th - only massage and electrical stimulation of the extensors. By the end of observation, proximal spasticity in the patients of Group 1 decreased 2.7-fold from baseline, distal spasticity decreased 1.8-fold; in Group 2, the decrease was 2.5-fold and 1.5-fold, respectively; in Group 3, it was 2-fold and 1.6-fold, respectively; in Group 4, it was 1.4-fold and 1.5-fold, respectively. By this time, Group 1 patients showed a 2.4-fold increase in shoulder range of motion; in Group 2, it was 2.2-fold; in Group 3, it was 1.9-fold; and in Group 4, it was 1.5-fold. We observed unidirectional changes in the mobility of the elbow and wrist joints, which highlighted the long-term benefits of complementing the standard therapy package with botulinum toxin treatment and neurofeedback.