Article

PURPOSE: To determine whether gait and mobility measures are responsive to change
following botulinum toxin (BoNT) injections in adults with lower limb spasticity.
METHOD: Independently ambulant adults who attended a spasticity clinic for lower
limb BoNT injections were eligible to participate. The 10 m walk test (shoes on
and off), timed up and go test and 6-min walk test were performed before
injection and 1 month later. Participants completed a global rating of change
scale (GRCS) at follow up. Comparisons were made between participants' ratings of
change and change in walking performance. Effect sizes (ES) and standard error of
measurement (SEM) were calculated for each outcome. RESULTS: Thirty-nine patients
(22 female, 17 male; mean age 51 +/- 12 years; range 26-74 years) with a median
spasticity duration of 53 months participated. Statistically significant changes
were found in all gait and mobility measures at 1 month following injection. All
ES were small (<0.2) and SEM for each measure was large. The global rating of
change scale (GRCS) indicated that 66% of participants perceived that their
walking had improved. However, there was a significant relationship between GRCS
and performance on walking tests for the 10 m walk test with shoes off (p = 0.01)
and timed up and go test (p = 0.02) only. CONCLUSION: Commonly used walking tests
may not be responsive to change following BoNT injection. The small ES suggest
that BoNT has a modest effect on walking ability. Tests of walking performance
may not be sufficient to capture all clinically relevant changes in walking
ability following BoNT injection of the lower limb.

Langue : ANGLAIS