Article

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. 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.

Langue : ANGLAIS