OBJECTIVE: To confirm the apparent effectiveness of botulinum toxin (BTX) in hemiparetic patients with ankle plantar flexors and foot invertor spasticity. METHODS:Twenty three hemiparetic patients with spasticity of the ankle plantar flexors and foot invertors were included in a randomised double blind, placebo controlled study with BTX. Patients were examined on days 0, 30, 90, and 120 and received one injection of BTX and one of placebo in a random order at day 0 and day 90. RESULTS: Patients reported a clear subjective improvement in foot spasticity after BTX (P = 0.0014) but not after placebo. Significant changes were noted in Ashworth scale values for ankle extensors (P < 0.0001) and invertors (P = 0.0002), and for active ankle dorsiflexion (P = 0.0001). Gait velocity was slightly but not significantly (P = 0.0731) improved after BTX injections. The severity of spasticity did not modify treatment efficacy, but BTX was less effective in patients with longer duration of spasticity (P = 0.0081). CONCLUSION: The efficacy of BTX injections in the treatment of spastic foot suggests that BTX may be particularly useful during the first year after a stroke.
RCT Entities:
OBJECTIVE: To confirm the apparent effectiveness of botulinum toxin (BTX) in hemiparetic patients with ankle plantar flexors and foot invertor spasticity. METHODS: Twenty three hemiparetic patients with spasticity of the ankle plantar flexors and foot invertors were included in a randomised double blind, placebo controlled study with BTX. Patients were examined on days 0, 30, 90, and 120 and received one injection of BTX and one of placebo in a random order at day 0 and day 90. RESULTS:Patients reported a clear subjective improvement in foot spasticity after BTX (P = 0.0014) but not after placebo. Significant changes were noted in Ashworth scale values for ankle extensors (P < 0.0001) and invertors (P = 0.0002), and for active ankle dorsiflexion (P = 0.0001). Gait velocity was slightly but not significantly (P = 0.0731) improved after BTX injections. The severity of spasticity did not modify treatment efficacy, but BTX was less effective in patients with longer duration of spasticity (P = 0.0081). CONCLUSION: The efficacy of BTX injections in the treatment of spastic foot suggests that BTX may be particularly useful during the first year after a stroke.
Authors: S Hesse; D Lücke; M Malezic; C Bertelt; H Friedrich; M Gregoric; K H Mauritz Journal: J Neurol Neurosurg Psychiatry Date: 1994-11 Impact factor: 10.154
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Authors: H P Francis; D T Wade; L Turner-Stokes; R S Kingswell; C S Dott; E A Coxon Journal: J Neurol Neurosurg Psychiatry Date: 2004-11 Impact factor: 10.154
Authors: D Richardson; G Sheean; D Werring; M Desai; S Edwards; R Greenwood; A Thompson Journal: J Neurol Neurosurg Psychiatry Date: 2000-10 Impact factor: 10.154
Authors: A Berardelli; G Abbruzzese; L Bertolasi; G Cantarella; F Carella; A Currà; D De Grandis; G DeFazio; G Galardi; P Girlanda; P Livrea; N Modugno; A Priori; G Ruoppolo; L Vacca; M Manfredi Journal: Ital J Neurol Sci Date: 1997-10