Gait improvement by low-dose botulinum toxin A injection treatment of the
lower limbs in subacute stroke patients |
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Authors: | Wu Tao Dong Yan Jian-Hua Li Zhao-Hong Shi |
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Institution: | 1) Department of Rehabilitation, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, China;2) Department of Rehabilitation Medicine, Hangzhou Hospital of Zhejiang CAPF, China;3) Department of Rehabilitation, First People’s Hospital of Wen-ling, China |
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Abstract: | Purpose] Lower-limb spasticity after stroke may be associated with worse functional
outcome. Our study aim was to establish whether a low-dose botulinum toxin A (BTX-A)
injection in subacute stroke patients can improve spasticity, gait, and daily living
abilities. Subjects] Twenty-three subacute stroke patients were randomly allocated to
BTX-A treatment group (11 patients) and control group (12 patients). Methods] In the
BTX-A treatment group patients, 200 units BTX-A was injected into the triceps surae (150
iu) and posterior tibial (50 iu) by electrical stimulation-guided. The patients in the
control group received the same volume of placebo solution into the same injection
locations. Gait analysis (step length, cadence, speed), the 6-min walking test, Fugl-Meyer
Assessment (FMA) of the lower limbs, modified Ashworth scale assess (MAS) assessment of
the lower limbs, surface electromyography (sEMG), and modified Barthel index (MBI)
assessment were performed before and at 4,8 weeks after treatment. Results] We found that
the FMA of the low limbs and MBI were significantly improved in both groups. The gait
analysis, FMA, and MBI results in the BTX-A treatment group were better than those in the
control group. MAS and surface electromyography (sEMG) showed better improvement of
spasticity in the treatment group. Conclusion] Early low-dose botulinum toxin A (BTX-A)
injection in subacute stroke patients into the lower-limb may improve gait, spasticity,
and daily living abilities.Key words: Botulinum toxin A, Stroke, Spasticity |
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