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Table 4.12 Percutaneous Phenol Block for the Treatment of Spasticity Post ABI

by | Dec 6, 2018

Table 4.12 Percutaneous Phenol Block for the Treatment of Spasticity Post ABI

Author Year Country Study Design Sample Size Methods Outcome
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°.