BOTULINUM TOXIN TREATMENT FOR LOWER-LIMB EXTENSOR SPASTICITY IN CHRONIC HEMIPARETIC PATIENTS
BOTULINUM TOXIN TREATMENT FOR LOWER-LIMB EXTENSOR SPASTICITY IN CHRONIC HEMIPARETIC PATIENTS
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DOI：
10.1136/jnnp.57.11.1321
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发表时间：
1994-11-01
影响因子：
11
通讯作者：
FRIEDRICH, H
中科院分区：
文献类型：
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作者：
HESSE, S;LUCKE, D;FRIEDRICH, H
12例慢性偏瘫患者明显的下肢伸肌痉挛，注射400单位的肉毒毒素A，肌电图引导到比目鱼肌，胫骨后肌，腓肠肌的两个头。根据Ashworth量表评估，10名患者在注射后两周，肉毒毒素A引起足底屈肌痉挛明显减少。其中4例患者能够实现其受累踝关节的主动背屈。步态分析（包括垂直地面反作用力的测量）显示，速度、步幅、站立对称性和受影响脚下的作用力点长度在统计学上显著改善（p < 0.01）。在7名患者中，力图的定性改善表明更好的载荷、身体前伸和患肢的推离。注射8周后，效果减弱。
Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including the measurement of vertical ground reaction forces showed a statistically significant (p < 0.01) improvement in velocity, stride length, stance symmetry, and the length of the force point of action under the affected foot. Qualitative improvements on the force diagrams indicated a better loading, advancement of the body, and push off of the affected limb in seven patients. Eight weeks after the injection the effects waned.