Keenan et al. (1990)

USA

Case Series

N=17

Population: TBI; Mean Age=25yr; Gender: Male=12, Female=5; Mean Time Post Injury=6mo.

Intervention: Subjects received a phenol block (3ml of 5% phenol solution in sterile saline) followed by a daily program of active/passive range of motion therapy. Assessments conducted pre-post block, 24hr after, then at weekly intervals while patients were hospitalized for rehabilitation.  Post discharge follow-up occurred for a minimum of 2yr.

Outcome Measure: Muscle tone/control, Range of Motion.

1.       Ninety-three percent of extremities showed a short-term decrease in motor tone and improved resting position of the elbow.

2.       Maximum improvements occurred 4wk post block.

3.       Resting position improved from 120° to 69°, active arc increased from 46° to 60°, and passive arc from 65° to 118°.

4.       At follow-up (mean 27mo post injection), 9 extremities that had relief of spasticity, had recurrence of flexor tone and loss of motion in the elbow.

Garland et al. (1984)

USA

Case Series

N=11

Population: TBI=11; Mean Age=24yr; Gender: Male=8, Female=3; Mean Time Post Injury=5.8mo.

Intervention: Subjects received percutaneous phenol injections (1-2ml of 3 or 5% phenol solution) at motor points of spastic wrist and finger flexors identified using a nerve stimulator. Injected muscles included: the flexor carpi radialis, flexor carpi ulnaris, flexor digitorum sublimus, flexor digitorum profundus, and flexor pollicis longus.

Outcome Measure: Resting Angle of Wrist, Passive/active Extension of Wrist.

1.       Mean resting position of the wrist prior to injection was 53°. Nine patients increased resting extension by a mean of 34° and 2 patients lost a mean of 15° of extension.

2.       Overall, there was a mean increase in resting wrist angle following motor point injections of 25°.

3.       Active wrist extension improved an average of 30°. Mean increase in passive wrist extension with finger flexed of 5°.