CVA-11 · Post-Stroke Shoulder and Pain Syndromes

Post-Stroke Shoulder and Pain Syndromes. Part of the Cerebrovascular / Stroke series of the Reflex PM&R Board Review podcast. Audio correction: In the audio: The peak effect, the maximum tone reduction, hits at two to six weeks post-injection — Correct: Peak effect is at ~3 WEEKS, not two to six weeks. Botulinum toxin for focal spasticity follows the rule of threes: onset ~3 days (24-72 hours), PEAK EFFECT ~3 WEEKS, duration ~3 months (3-4 months), with re-injection no sooner than every 3 months (12 weeks). The audio's onset (three to seven days) and duration (three to four months) bracket the canonical figures; only the peak window is superseded. The written chapter is correct. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/CVA-11.