Short-term electrical stimulation enhances the effectiveness of Botulinum toxin in the treatment of lower limb spasticity in hemiparetic patients.
The study tested the spasmolytic effect of Botulinum toxin A in two groups of hemiparetic patients with lower limb spasticity: in the first group (n = 5) 2000 U Dysport were injected into the soleus, tibialis posterior and both heads of gastrocnemius muscles alone; the second (n = 5) received additional repetitive alternating electrical stimulation of M. tibialis anterior and plantar flexors for 30 min six times per day during the 3 days following the injection. Muscle tone, rated by the Ashworth spasticity score, and gait analysis including recording of vertical ground reaction forces, were assessed before and 4 weeks after injection. The combined treatment proved to be more effective with respect to the clinically assessed reduction of muscle tone, gait velocity, stride length, stance- and swing-symmetry (P < 0.05). The result is discussed with reference to animal experiments demonstrating enhanced toxin uptake and accelerated onset of its paralytic effect by electrical stimulation.
Hesse
S
S
Department of Neurological Rehabilitation, Free University Berlin, Germany.
Jahnke
M T
MT
Luecke
D
D
Mauritz
K H
KH
D000328:Adult; D000368:Aged; D018726:Anti-Dyskinesia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000009:adverse effects / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000150:complications; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D004576:Electromyography; D005260:Female; D006429:Hemiplegia / Q000150:complications* / Q000209:etiology; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D016138:Walking
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins