Meaningful improvement in walking performance after Botulinum neurotoxin A (BoNT-A) in chronic spastic patients.

Abstract

BACKGROUND:

Botulinum neurotoxin A (BoNT-A) may reduce lower limb spasticity but its role in improving walking ability remains to be established.

OBJECTIVE:

To investigate the efficacy of simultaneous BoNT-A injections into several targeted spastic muscles of different joints on gait speed and on functional gains in gait performance in chronic stroke and MS patients.

METHODS:

Twenty patients affected by stroke or multiple sclerosis were tested before, one and three months after BoNT-A administration. Gait was evaluated by the 10 Meter Walk Test; patients were stratified into functional ambulation classes accordingly. Spasticity was assessed using the modified Ashworth Scale.

RESULTS:

At final assessment, spasticity was reduced in hip adductors and ankle plantar-flexors, gait speed improved and, 1/3rd of patients transitioned to a higher ambulation class. The pre-post difference in Level of Spasticity of the hips was a predictor for an increase in gait speed.

CONCLUSIONS:

A meaningful improvement in walking performance can be obtained in chronic spastic patients after BoNT-A injection into several muscles, specifically the hip adductors.

• Authors: David Cioncoloni, Sabrina Taddei, Silvia Bielli, Pasquale Annunziata, Riccardo Mazzocchio
• Journal: NeuroRehabilitation (NeuroRehabilitation) Vol. 34 Issue 1 Pg. 185-92 ( 2014) ISSN: 1878-6448 [Electronic] Netherlands
• PMID: 24284465 (Publication Type: Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Aged
• Botulinum Toxins, Type A (therapeutic use)
• Chronic Disease
• Female
• Gait
• Humans
• Male
• Middle Aged
• Multiple Sclerosis (complications, physiopathology)
• Muscle Spasticity (complications, drug therapy)
• Neuromuscular Agents (therapeutic use)
• Recovery of Function
• Stroke (complications, physiopathology)
• Walking