1540 - Phenol injections to Musculocutaneous nerves to treat spastic elbow flexor muscles for post-stroke men and women

The study aims to evaluate the efficacy of phenol injections to the musculocutaneous nerve (MCN) for reducing spasticity in post-stroke elbow flexor muscles in both men and women. A secondary objective is to examine potential gender differences in response and assess adverse effects.

Design:

Retrospective chart review on post-stroke patients with spastic elbow flexors, with 5% phenol injections to the MCN. Outcome measures included E-stim to identify nerves; number of sites injected on MCN; total phenol dose injected per nerve; phenol injected per site; Modified Ashworth Scale (MAS) pre-and-post-injections within and between genders. Statistical analysis was conducted using Welch's t-test, continuous data reported as mean (+SD); Mann-Whitney U & Wilcoxon Rank Sum tests for ordinal data, & reported as median (Interquartile range, IQR). Significance at p< 0.05 level.

Results:

For men (n=33) versus women (n=34), there were no significant differences: for age 63.9(12.3) vs 67.8(15.6); right-hand dominance 75% vs 88%; right hemiparetic side 39% vs 41%; E-stim 0.49(0.12) vs 0.52(0.18)mA; number of sites injected on each MCN 1.33(0.59) vs 1.32(0.53); phenol injected per site on each nerve 0.60(.49) vs 0.50(.30) ml; and total phenol injected/nerve 0.76(.73) vs 0.59(.36) ml. MAS was not different (P >0.05) between genders pre-injection or post-injection.MAS pre- vs post-injection decreased (p< 0.001) for men from 3.0(3-3.5) to 0(0-1.5), and for women from 3.0(3-4) to 1.0(0-2).