Article

There is evidence that Botulinum Toxin-A (BTX-A) reduces focal
spasticity associated with equinovarus to improve gait in patients poststroke.
However, there is little research examining whether gait improvements are
maintained after the effectiveness period of BTX-A injections. The purpose of
this observational study was to determine whether there was a difference in gait
parameters in three patients before BTX-A injection versus four and ten weeks
after. CASE SERIES: Three women, ages 63, 60, and 42 postischemic stroke with
hemiparesis and equinovarus underwent measurements for: plantar flexor
spasticity, ankle dorsiflexion ROM, temporal-spatial gait parameters, and gait
endurance. All participants improved in ankle ROM. At week 10, spasticity had
returned to initial measurement levels in participants A and C. Base of support
and step length symmetry ratios did not improve following injections.
Participants A and B, who received physical therapy during the study, showed
modest gains in gait endurance and velocity. CONCLUSION: Although BTX-A
injections improved spasticity, this improvement did not translate to gait
outcomes. Addition of physical therapy interventions appeared to improve gait
outcomes in this case series. We suggest future randomized control studies to
compare effects of physical therapy alone to BTX-A combined with physical therapy
on gait outcomes.

Langue : ANGLAIS