Potential benefits for caregivers of stroke survivors receiving BTX-A and exercise for upper extremity spasticity

Rehabil Nurs. 2015 May-Jun;40(3):188-96. doi: 10.1002/rnj.147. Epub 2014 Mar 13.

Abstract

Purpose: To explore possible extended benefits to caregivers of stroke survivors receiving a treatment of onabotulinumtoxinA (BTX-A) or saline with a structured exercise program.

Design: A comparative, prospective, companion study using a nonrandom sample of 16 caregivers of stroke survivors enrolled in a pilot clinical trial comparing BTX-A or saline and exercise for upper extremity spasticity.

Methods: The caregiver measures were depressive symptoms, care demands, family conflict surrounding stroke recovery, and mental and physical health status.

Findings: There were no statistically significant differences between caregiver groups. Caregivers of stroke survivors who received BTX-A had a greater change in depressive symptoms that may reflect a clinically important change. Estimates of effect sizes between the groups, controlling for baseline values, indicate a trend for moderate to large effects (last evaluation) for fewer depressive symptoms (d = 0.52) and less caregiver burden (d = 0.77 time, 0.85 difficulty) for caregivers of the BTX-A group.

Conclusions and clinical relevance: Receiving BTX-A did not alter caregiving demands or depressive symptoms compared to those receiving saline. Further research with larger sample sizes is needed to better understand the interdependence of stroke survivors and caregivers on the health of each.

Keywords: Stroke; family caregiving; rehabilitation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcholine Release Inhibitors / therapeutic use*
  • Activities of Daily Living
  • Adaptation, Psychological
  • Adult
  • Aged
  • Aged, 80 and over
  • Botulinum Toxins, Type A / therapeutic use*
  • Caregivers / psychology*
  • Depressive Disorder / complications
  • Depressive Disorder / prevention & control
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / etiology
  • Muscle Spasticity / therapy*
  • Prospective Studies
  • Quality of Life
  • Rehabilitation Nursing / methods
  • Stroke / complications
  • Stroke / drug therapy*
  • Stroke Rehabilitation*
  • Upper Extremity

Substances

  • Acetylcholine Release Inhibitors
  • Botulinum Toxins, Type A