A single-blinded, randomized pilot study of botulinum toxin type A combined with non-pharmacological treatment for spastic foot.
OBJECTIVE
To explore the effect of treatment after botulinum toxin type A combined with treatments for the spastic foot.


METHODS
Single-blind, randomized trial, with 3-month follow-up.


METHODS
Twenty-three chronic hemiplegic adult patients with spastic equinus foot.


METHODS
Following botulinum toxin type A injection at the medial and lateral gastrocnemius, patients were assigned randomly to 3 groups, and treated with taping, electrical stimulation or stretching. They were evaluated before treatment (t0), and at 10 (t1), 20 (t2) and 90 (t3) days after treatment. Outcome measures were: Modified Ashworth Scale; passive range of motion at the ankle; measurement of muscle action potential at the gastrocnemius medialis; and measurement of maximum ankle dorsiflexion angle in stance using gait analysis.


RESULTS
The group treated with electrical stimulation performed better at t1 on the Modified Ashworth Scale. The taping and electrical stimulation groups performed better in all outcome measures at t3. The taping group performed better mainly for maximum ankle dorsiflexion angle in stance. The stretching group showed a less durable result, with some worsening at the t3 evaluation compared with the assessment performed before treatment.


CONCLUSIONS
This pilot study indicates that combining botulinum toxin type A administration for the ankle plantar flexors with taping and electrical stimulation might be beneficial.
Baricich
Alessio
A
CRRF Mons. Luigi Novarese, Physical Medicine & Rehabilitation School, University of Eastern Piedmont Amedeo Avogadro, Moncrivello, Italy. alessio.bar@gmail.com
Carda
Stefano
S
Bertoni
Michele
M
Maderna
Luca
L
Cisari
Carlo
C
D000328:Adult; D000368:Aged; D001458:Bandages; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000503:physiopathology*; D020233:Gait Disorders, Neurologic / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D052580:Muscle Stretching Exercises; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D016059:Range of Motion, Articular; D013165:Splints; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A