Botulinum toxin treatment for lower limb extensor spasticity in chronic hemiparetic patients.
Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including the measurement of vertical ground reaction forces showed a statistically significant (p < 0.01) improvement in velocity, stride length, stance symmetry, and the length of the force point of action under the affected foot. Qualitative improvements on the force diagrams indicated a better loading, advancement of the body, and push off of the affected limb in seven patients. Eight weeks after the injection the effects waned.
Klinik Berlin, Department of Neurological Rehabilitation, Free University of Berlin, Germany.
S
S
Hesse
D
D
Lücke
M
M
Malezic
C
C
Bertelt
H
H
Friedrich
M
M
Gregoric
K H
KH
Mauritz
D000328:Adult; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000150:complications; D002908:Chronic Disease; D005260:Female; D005684:Gait / Q000187:drug effects; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007273:Injections, Intramuscular; D007866:Leg; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016896:Treatment Outcome
D001905:Botulinum Toxins