Effects of botulinum toxin type A injection on the walking ability of stroke survivors with spastic foot drop and talipes varus
10.3760/cma.j.issn.0254-1424.2018.12.005
- VernacularTitle:胫骨前肌注射A型肉毒毒素对脑卒中痉挛性足下垂和足内翻患者步行功能的影响
- Author:
Yongxiang ZHANG
1
;
Wenjie ZHANG
;
Qiang WANG
;
Jiang LI
;
Chao HAN
;
Yanguang DONG
;
Chuanmei YANG
Author Information
1. 青岛大学附属医院康复科
- Keywords:
Stroke;
Spasticity;
Botulinum toxin type A;
Ankles;
Gait;
Club foot;
Foot drop
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2018;40(12):899-902
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effect of injecting botulinum toxin type A ( BTX-A) into the tibialis anterior muscle on spasm and the walking function of stroke survivors with spastic foot drop and strephenopodia. Methods Fifty-six stroke survivors with spastic foot drop and strephenopodia were randomly divided into a tibialis anterior injection group ( Group TA) and a conventional injection group ( Group CG) , each of 28. Both groups had 50 U of BTX-A injected into the medial-lateral heads of the affected gastrocnemius and soleus muscles, and 35 U in-jected into each of two sites in the tibialis posterior. Group TA was additionally injected with 30 U in the tibialis ante-rior. Before the injection, as well as 2, 4 and 12 weeks afterward, both groups were evaluated using the modified Ashworth scale (MAS) for the plantar flexors and varus muscle groups, a 10-minute walking test (10 m-WT), a simple Fugl-Meyer assessment ( FMA) of the lower limb and a timed up and go test ( TUG) . Results Before the injection, there were no statistically significant differences in the average MAS, 10 m-WT, FMA or TUG results be-tween the two groups. After 2 weeks, however, the average MAS score of both groups had decreased significantly, and that improvement was maintained at 4 and 12 weeks after the injection. Moreover, 2, 4 and 12 weeks after the injec-tion, significant differences in the average MAS score were observed between the two groups. The average 10m-WT re-sults, FMA scores and TUG times of both groups also improved significantly, but there were significant differences between the two groups′10m-WT times and FMA scores after 2 and 4 weeks. Conclusions Injecting a small dose of BTX-A into the tibialis anterior can further relieve spasm in the tibialis anterior muscle and improve the walking a-bility of stroke survivors with spastic foot drop and strephenopodia.
