Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study.
Abstract
[BACKGROUND] Botulinum toxin type A (BoNT-A) injection is an effective treatment for lower-limb spasticity and should be offered as first-line treatment for focal manifestations. Although its possible role has been hypothesized, the efficacy of electrical stimulation (ES) of antagonists of the injected muscles for improving clinical outcome after BoNT-A injection remains to be established.
[OBJECTIVES] This randomized single-blind pilot study aimed to investigate the efficacy of ES of antagonist muscles as adjunct treatment after BoNT-A injection to plantar flexor muscles in hemiplegic patients with spastic equinus foot.
[METHODS] After BoNT-A injection at triceps surae, patients were randomly allocated to 2 groups: group 1, single ES session on injected muscles plus 5 sessions of ES on antagonist muscles, and group 2, single ES session on injected muscles alone. Both groups underwent daily physical therapy for 60min for 2 weeks (5 days/week). Assessments were performed before treatment (T) and at 10 days (T), 20 days (T), and 90 days (T) after treatment. Our primary outcome was gait velocity at a comfortable speed at T (10-m walk test [10MWT]). The following were secondary outcomes: triceps surae spasticity (Modified Ashworth Scale), ankle passive range of motion (pROM), strength of tibialis anterior muscle, and 2-min walk test (2MWT).
[RESULTS] The 30 patients enrolled were randomly allocated to the 2 groups: 15 in group 1 and 15 in group 2. At T, T and T, both groups showed a significant reduction in muscle tone and an increase in ankle pROM (P<0.05). At T and T, both groups showed a significant increase in 10MWT and 2MWT. The groups did not significantly differ in tibialis anterior strength or primary or secondary outcome measures.
[CONCLUSIONS] ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection.
[OBJECTIVES] This randomized single-blind pilot study aimed to investigate the efficacy of ES of antagonist muscles as adjunct treatment after BoNT-A injection to plantar flexor muscles in hemiplegic patients with spastic equinus foot.
[METHODS] After BoNT-A injection at triceps surae, patients were randomly allocated to 2 groups: group 1, single ES session on injected muscles plus 5 sessions of ES on antagonist muscles, and group 2, single ES session on injected muscles alone. Both groups underwent daily physical therapy for 60min for 2 weeks (5 days/week). Assessments were performed before treatment (T) and at 10 days (T), 20 days (T), and 90 days (T) after treatment. Our primary outcome was gait velocity at a comfortable speed at T (10-m walk test [10MWT]). The following were secondary outcomes: triceps surae spasticity (Modified Ashworth Scale), ankle passive range of motion (pROM), strength of tibialis anterior muscle, and 2-min walk test (2MWT).
[RESULTS] The 30 patients enrolled were randomly allocated to the 2 groups: 15 in group 1 and 15 in group 2. At T, T and T, both groups showed a significant reduction in muscle tone and an increase in ankle pROM (P<0.05). At T and T, both groups showed a significant increase in 10MWT and 2MWT. The groups did not significantly differ in tibialis anterior strength or primary or secondary outcome measures.
[CONCLUSIONS] ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | botulinum toxin
|
보툴리눔독소 주사 | dict | 2 |
MeSH Terms
Aged; Botulinum Toxins, Type A; Combined Modality Therapy; Electric Stimulation Therapy; Equinus Deformity; Female; Hemiplegia; Humans; Leg; Male; Middle Aged; Muscle Spasticity; Neuromuscular Agents; Physical Endurance; Pilot Projects; Recovery of Function; Single-Blind Method; Stroke; Stroke Rehabilitation; Treatment Outcome
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