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EFFECT OF BOTULINUM TOXIN AND TASK SPECIFIC TRAINING ON QUALITY OF LIFE IN POST STROKE FOCAL HAND DYSTONIA

Muhammad Umar, Naveed Babur, Irfan Afzal Mughal,Mazhar Badshah, Mirza Shamim Baig

Objective: To find the impact of Botulinum toxin type A and task specific training in improving the quality of life of patients with post stroke focal dystonia of upper limb and to determine the association of quality of life with hand dystonia and functional outcomes. Study Design: Quasi experimental study Place & Duration: Physiotherapy department Holy Family Hospital Rawalpindi, Chambeli Rehabilitation Center Rawalpindi and The Neurocounsel Islamabad from October 2015 to December 2016. Methodology: A total of 23 patients fulfilling the inclusion and exclusion criteria were recruited using purposive sampling. All patients enrolled in the study were injected with Botulinum toxin type A followed by task specific training. Patients were evaluated at baseline, week 4 and week 8 using; Arm dystonia disability Scale, Fugl-Meyer Assessment scale of upper limb and Stroke specific quality of life scale. Results: The mean age of the study population was 43.57±10.94 years, with 71.4 % (n= 15) of male and 28.6 % (n=6) females. There was an improvement in severity of dystonia from baseline to week 8 after the interventions, hand functions also improved. The mean scores of SS-QOL and FMA-UL also showed significant differences over the time period as shown by repeated measures ANOVA (P value <0.001). Conclusion: Botulinum toxin type A when provided with task specific training, not only improved the dystonia but also improved the functions of the upper limb, which in returns improved the quality of life of patients presenting with post stroke focal hand dystonia. Keywords: Botulinum toxin type A, Dystonia, Quality of Life, Stroke, Physiotherapy, Task specific training.

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