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Neurological Rehabilitation

Phenol injections to obturator nerves to treat spastic hip adductor muscles for post-stroke men and women.

(Research Hub Theater) Phenol Injections to Obturator Nerves to Treat Spastic Hip Adductor Muscles for Post-stroke Men and Women

Friday, November 17, 2023
12:00 PM – 1:45 PM CT

    Primary Author(s)

  • Abraham Alfaro, DO, PhD

    Consultant for a Rehabilitation Medicine Clinic
    AtlantiCare Health Services: Federally Qualified Health Center
    Linwood, New Jersey

    • Co-Author(s)

  • MA

    Motasem Abul-Huda, DO

    Medical Student
    Rowan University School of Osteopathic Medicine
    Clementon, New Jersey

    • Primary Author(s)

  • Ekrem H. Cetinkaya, Student

    Medical Student Researcher
    Rowan-Virtua School of Osteopathic Medicine
    Philadelphia, Pennsylvania

Background and/or Objectives: To assess the effects of phenol injections to obturator nerves to treat post-stroke spastic hip adductor muscles for men and women.

Design: Retrospective chart review for post-stroke men and women who have spastic hip adductor muscles, and received obturator nerve injections with 5% phenol.

Setting: Outpatient rehabilitation medicine clinic.

Participants: Post-stroke men and women who have spastic hip adductor muscles and received obturator nerve injections with 5% phenol.

Interventions: Phenol 5% injections to obturator nerves that were identified with anatomical landmarks and electrical stimulation (E-stim).

Main Outcome Measures: E-stim to identify nerves; number of sites injected on obturator nerves; total phenol dose injected per nerve; phenol injected per site; Modified Ashworth Scale (MAS) pre- and post-injection between and within genders. Data was statistically analyzed: with Welch's t-test for continuous data and reported as mean (SD); and with Mann-Whitney U and Wilcoxon Rank Sum tests for ordinal data, and reported as median (Interquartile range, IQR). Statistical significance was at the p< 0.05 level.

Results: For men (n=31) versus women (n=25), there were no significant differences: for age 68.8 (13.9) vs 70.0 (15.90); right hand dominance 94% vs 84%; right hemiparetic side 52% vs 48%; E-stim 0.53 (0.12) vs 0.56 (0.15) mA; total phenol injected/nerve 1.15 (0.63) vs 1.11 (0.83) ml; and phenol injected per site on each nerve 0.79 (0.42) vs 0.87 (0.56) ml. The number of sites injected on each obturator nerve was higher for men 1.68 (0.75) than for women 1.28 (0.46) p< 0.05). MAS was not different (p>0.05) between genders either pre-injection or post-injection. MAS pre- vs post-injection decreased (p < 0.05) for men from 3.0 (2.5-3.5) to 0 (0-1.0), and for women from 3.0 (2.75-3.0) to 1.0 (0-1.0).

Conclusions: Phenol injections to obturator nerves immediately decreased hip adductor muscle spasticity for post-stroke men and women.