Comparison of botulinum toxin injection and neurotomy in patients with distal lower limb spasticity.
Eur J Neurol
; 15(5): 506-11, 2008 May.
Article
em En
| MEDLINE
| ID: mdl-18325022
ABSTRACT
BACKGROUND AND PURPOSE:
We compared the efficacy of botulinum toxin injection (BTI) and tibial nerve neurotomy (TNN) in an open-label study of 34 post-stroke hemiplegic patients with distal lower limb deformation.METHODS:
The dose of BT was 300 U (Botox). TNN was performed with a 6-12 month delay on the motor branches of the tibial nerve. Muscles to be treated were selected according to the distal deformity (equinus, varus and clawing toes). Patients were assessed following each treatment for spasticity, motor control, range of movements, balance, gait and the Rivermead Motor Assessment.RESULTS:
TNN (M3, M6 and Y1) resulted in a more significant effect than BTI (D15, M2 and M5) on most of themeasures:
ankle plantar flexor spasticity, range of movement in dorsiflexion and eversion, foot position in upright situation, Functional Ambulation Categories (barefoot), RMA, gait velocity (comfortable condition), subjective benefit and use of walking aids. Patients treated for tibialis posterior or flexor digitorum longus spasticity often complained of subjective sensory disorders at the plantar sole over a period of 4-6 weeks.CONCLUSION:
In conclusion, TNN is more effective than BTI on most of the functional parameters. The interest of BTI lies in the preliminary testing of the efficacy of a technique for reducing spasticity on lower limb function.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Toxinas Botulínicas Tipo A
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Extremidade Inferior
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Espasticidade Muscular
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Fármacos Neuromusculares
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Neurol
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
França