BACKGROUND:Botulinum toxin injections are used to treat spasticity in stroke. Although this treatment is effective on muscle tone, its effect on functional gait-related activities remains uncertain. OBJECTIVE: The aim of this randomized controlled trial was to determine the effect of a self-rehabilitation programme as an adjunct to botulinum toxin injections on gait-related activities in patients with chronic hemiparesis. METHODS:Thirty-five outpatients were included. Each patient was randomized to 1 of 2 groups: botulinum toxin + standardized self-rehabilitation programme (R group, n = 19) or botulinum toxin alone (C group, n = 16). Each patient was evaluated with the following tests before botulinum toxin injections and one month afterwards: 10-m timed walk, Timed Up and Go, distance covered in 6 min over an ecological circuit, and the stair test. RESULTS: There were significant improvements in the R group compared with the C group: maximal gait speed improved by 8% (p = 0.003); distance covered in 6 min over an ecological circuit increased by 7.1% (p = 0.01); and time to ascend and to descend a flight of stairs decreased by 9.8% (p = 0.003) and 6.6% (p = 0.009), respectively. The self-rehabilitation programme was well tolerated and safe. CONCLUSION: These results strongly suggest that a standardized self-rehabilitation programme constitutes a useful adjunct to botulinum toxin injections in order to improve gait-related activities.
RCT Entities:
BACKGROUND: Botulinum toxin injections are used to treat spasticity in stroke. Although this treatment is effective on muscle tone, its effect on functional gait-related activities remains uncertain. OBJECTIVE: The aim of this randomized controlled trial was to determine the effect of a self-rehabilitation programme as an adjunct to botulinum toxin injections on gait-related activities in patients with chronic hemiparesis. METHODS: Thirty-five outpatients were included. Each patient was randomized to 1 of 2 groups: botulinum toxin + standardized self-rehabilitation programme (R group, n = 19) or botulinum toxin alone (C group, n = 16). Each patient was evaluated with the following tests before botulinum toxin injections and one month afterwards: 10-m timed walk, Timed Up and Go, distance covered in 6 min over an ecological circuit, and the stair test. RESULTS: There were significant improvements in the R group compared with the C group: maximal gait speed improved by 8% (p = 0.003); distance covered in 6 min over an ecological circuit increased by 7.1% (p = 0.01); and time to ascend and to descend a flight of stairs decreased by 9.8% (p = 0.003) and 6.6% (p = 0.009), respectively. The self-rehabilitation programme was well tolerated and safe. CONCLUSION: These results strongly suggest that a standardized self-rehabilitation programme constitutes a useful adjunct to botulinum toxin injections in order to improve gait-related activities.
Authors: Celine Bonnyaud; Philippe Gallien; Pierre Decavel; Philippe Marque; Claire Aymard; Frédéric Pellas; Marie-Eve Isner; François Constant Boyer; François Muller; Jean-Christophe Daviet; Patrick Dehail; Brigitte Perrouin-Verbe; Nicolas Bayle; Emmanuel Coudeyre; Dominic Perennou; Isabelle Laffont; Jacques Ropers; Nabila-Yasmine Domingo-Saidji; Djamel Bensmail; Nicolas Roche Journal: BMJ Open Date: 2018-08-30 Impact factor: 2.692
Authors: Harald Hefter; Werner Nickels; Dietmar Rosenthal; Sara Samadzadeh; Philipp Albrecht Journal: Toxins (Basel) Date: 2021-07-02 Impact factor: 4.546