Limitations
post-stroke, upper limb spasticity
This study had some limitations. First, we did not include a placebo group for comparison. It is important to note that previous placebo-controlled trials have already established the efficacy of BXT-A injections, which have become a standard treatment for post-stroke upper limb spasticity. Consequently, it was deemed ethically inappropriate to administer placebo injections to these patients. Second, the study duration was relatively short. It is necessary to conduct long-term follow-up assessments to evaluate the sustained effects of the treatment. Finally, patients were included in this trial if they were receiving muscle relaxants or anti-spasticity drugs at a constant dose, and if they had been receiving physiotherapy for more than 4 weeks at the time of screening and were not expected to change during the trial. The stable dose of medication may not have been strictly monitored, and the short-term effect of physiotherapy at the time of assessment may be a potential bias.