The Effects of Botulinum Toxin Injections on Plantar Flexor Spasticity in Different Phases After Stroke: A Secondary Analysis From a Double-Blind, Randomized Trial.

Authors
Hyun‐Mi OhGeun‐Young ParkYoung Min ChoiHyung Jung KooYongjun JangSun Im MD
Department
Dept. of Rehabilitation Medicine (재활의학)
Issue Date
2018
Citation
PM & R : the journal of injury, function, and rehabilitation, Vol.10(8) : 789-797, 2018
ISSN
1934-1482
Abstract
BACKGROUND: There are no guidelines on the ideal time to inject botulinum toxin type A (BT-A) for lower leg spasticity in stroke patients. An early injection may produce unwanted weakness, interfering with gait recovery. OBJECTIVE: To evaluate whether the outcomes after BT-A injection for plantarflexion spasticity can be different according to stroke chronicity. DESIGN: A secondary analysis study from a double-blinded, randomized trial with group reclassification according to stroke chronicity. SETTING: Two rehabilitation centers. PARTICIPANTS: Stroke participants (n = 40) with plantar flexor spasticity, treated with BT-A (200 units) into the gastrocnemius muscle. METHODS: Outcome parameters were reanalyzed serially using 2-way repeated measures of analysis of variance (ANOVA), at baseline and 2, 4, and 8 weeks postinjection. Subjects were reclassified into 3 groups: early, within 6 months (n = 12); middle, between 6 months and 1 year (n = 14); and late, between 1 and 2 years from stroke onset (n = 12). MAIN OUTCOME MEASURES: The Modified Ashworth Scale, clonus scale, 10-m walking test, ABILOCO, and the Functional Ambulation Category. RESULTS: The 2-way repeated measures of ANOVA showed improvement in gait and spasticity after injection in the 3 groups. Significant improvement in the Modified Ashworth Scale (P < .001) was observed, starting from the post-2 week injection period. Improvement of gait as assessed by the functional measurement ABILOCO and the Functional Ambulation Category (P < .001) were observed in all 3 groups, mostly at the post-8 week injection period. CONCLUSIONS: Our serial measurements of the outcome parameters indicated that BT-A could be expected to lead to consistent improvement in both the muscle tone and gait quality in those with plantar flexor spasticity regardless of stroke chronicity, including those injected as early as within the first 6 months.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/41520
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
Keimyung Author(s)
최용민
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1016/j.pmrj.2018.02.011
File in this Item
 사서에게 요청하기
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE