Rick P
First post

Looking to exchange information or share experiences using Botox injection treatments coupled with therapy to fight upper arm spacicity.

Started the injections last year (2016) and therapy (arm and hand this year) 2017

Would like to compare notes about a treatment that seems to help

Thank you
Rick P
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strokerehab
Hi Rick,

I am an occupational therapist. What I usually see with the botox is a reduction in spasticity and sometimes discomfort, but patients often are not satisfied with the results they get. This is often because they are expecting more function in the arm/hand after a reduction in the spasticity, but they often find they have very little if any increase in functional use of the hand. On the other hand, if the spasticity is too high, it may be too difficult to do anything, so botox will at least let the patient try to start moving and using the hand/arm. It's often best to combine botox treatment with neuromuscular electrical stimulation (NMES), but that is something that should be discussed with your MD and therapist. I am an advocate of using botox especially when spasticity interferes with therapy/movement. I think patients often have very high expectations and are disappointed if they don't see changes quickly, so my advice is to work hard and try to be patient before coming to a conclusion about the effects of botox. It is not a miracle cure where the hand/arm will start moving and working. The purpose is to reduce the spasticity so that the patient has a better opportunity to move/recover.  Good luck with your treatment, and remember that repetition of movements and trying to use the hand/arm often on a daily basis (not just during therapy) is key to improving use.
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Rick P
Rick P

As follow up to the OT generated answer to my question about Botox and therapy, I found the answer to be very useful as to plotting a path forward.
The observations made were very good and extremely useful in my case.
My only adder would be that with the use of Botox, periods of warm and gentle heat applied for 2 hrs or so will be helpful in generating flexibility. I have also found that using therapy balls of various diameters working up to a regulation size softball will also help in fighting tone and increase the flexibility of the fingers as your hand learns how to pick up and hold.

I greatly appreciate the feedback and will post rehab comments or questions as they arise

Thanks Rick P
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