Botulinum toxin type A under ultrasound guidance for treating plantar flexor spasticity on different stages after stroke

doi:10.3969/j.issn.2095-4344.1375

Abstract

Abstract:

BACKGROUND: The ideal time of botulinum toxin A for treating lower limb spasm of stoke patients still remains controversial.
OBJECTIVE: To evaluate whether the outcomes after botulinum toxin A injection for plantar flexion spasticity can be different according to stroke chronicity.
METHODS: Ninety-seven patients with metatarsal flexor spasm after stroke were enrolled, 6 cases of loss to follow up. The study was in accordance with the ethics requirement of the First Affiliated Hospital of Guangxi Medical University. The patients were allocated into three groups based on onset time: early-term (within 6 months, n=30), middle-term (6-12 months, n=29), and late-term (1-2 years, n=32). The patients received 100 U botulinum toxin A injection at the gastrocnemius and soleus (for patients combined with varus, 80 U botulinum toxin A injection at the tibialis posterior) under ultrasound guidance, two injection points at each muscle. After injection, conventional rehabilitation training was conducted, once daily, six times per week for 8 consecutive weeks. The Modified Ashworth Scale, 10-meter walking test and Functional Ambulation Category were used for outcome evaluation at 2, 4 and 8 weeks after administration.
RESULTS AND CONCLUSION: (1) The gait and spasm degree after administration were improved in all groups. Significant improvement in the Modified Ashworth Scale (P < 0.001) was observed at 2 week post-injection. (2) There was a significant difference in Functional Ambulation Category (P < 0.001) in all three groups at 4 and 8 weeks post-injection. (3) The early-term group of the 10-m walking test produced a great change in gait speed. (4) These results indicate that for patients with plantar flexor spasticity after stroke at different stages, botulinum toxin A treatment is expected to continuously reduce muscle tension and improve the gait. The effect is especially pronounced in patients who have been treated within 6 months.

Key words: botulinum toxin type A, spasticity, ultrasound guidance, stroke, plantar flexion spasticity, clinical rehabilitation

CLC Number:

Ma Shanxin, Xu Jianwen, Long Yaobin, Huang Lang, Fu Shuisheng, Su Yiji, Liu Ying. Botulinum toxin type A under ultrasound guidance for treating plantar flexor spasticity on different stages after stroke[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(27): 4300-4304.

Figures/Tables 3

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