Modification of altered ankle motor control after stroke using focal application of botulinum toxin type A.

Abstract

STUDY DESIGN:

Blinded, placebo-controlled, prospective clinical trial.

PURPOSE:

To examine the effects of botulinum toxin type A (BTX-A) injections into plantar flexor muscles in stroke patients with equinovarus gait.

SUBJECTS:

15 post-stroke and 10 matched neurologically intact subjects.

METHODS:

Modified Ashworth Scale (MAS) and Fugl-Meyer assessment of physical function scale scores along with surface EMG collected before and up to 12 weeks after BTX-A injections to plantar flexor muscle motor points in stroke subjects. Saline placebo injections were performed in a subset of stroke subject group.

RESULTS:

MAS scores were decreased at 4, 8 and 12 weeks but F-M scores did not improve until 12 weeks post injection. Multi-muscle EMG patterns showed the return of volitional dorsiflexor activity in 11 and a decrease of antagonistic and distant coactivation in all but one of the 15.

CONCLUSIONS:

BTX-A is effective in reducing antagonistic and distant muscle activation that impedes volitional dorsiflexion.

• Authors: Simon F Tang, Jia-Pei Hong, William Barry McKay, Chu-Wen Tang, Pei-Hsuan Wu, Ngok-Kiu Chu
• Journal: Clinical neurology and neurosurgery (Clin Neurol Neurosurg) Vol. 114 Issue 5 Pg. 498-501 (Jun 2012) ISSN: 1872-6968 [Electronic] Netherlands
• PMID: 22480620 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2012 Elsevier B.V. All rights reserved.

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Aged
• Ankle (physiopathology)
• Ankle Joint (physiopathology)
• Botulinum Toxins, Type A (therapeutic use)
• Denervation
• Double-Blind Method
• Electromyography
• Exercise
• Female
• Gait Disorders, Neurologic (etiology, therapy)
• Hemiplegia (etiology, therapy)
• Humans
• Knee (physiopathology)
• Male
• Middle Aged
• Movement
• Movement Disorders (drug therapy, etiology, physiopathology, therapy)
• Neuromuscular Agents (therapeutic use)
• Stroke (complications)