The effects of botulinum toxin treatment on associated reactions of the upper limb on hemiplegic gait - a pilot study
The effects of botulinum toxin treatment on associated reactions of the upper limb on hemiplegic gait - a pilot study
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DOI：
10.1080/09638280110112891
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发表时间：
2002-07-01
影响因子：
2.2
通讯作者：
Sawyer, J
中科院分区：
文献类型：
--
作者：
Bakheit, AMO;Sawyer, J
目的：瘫痪者在上肢运动和其他运动活动中的不自主运动被称为相关上肢反应（AR）。80%的中风痉挛性偏瘫患者会发生AR，并且经常干扰平衡和安全活动。据推测，治疗局部肌肉痉挛与肉毒杆菌毒素A型（BtxA）将取消AR和改善平衡和mobility.Method：这一假设将需要在一个随机对照试验（RCT）进行测试。本试点研究的目的是获得初步数据，为未来RCT的设计提供信息。8名患者接受了500单位BtxA的单次注射（Dysport（R）Ipsen，Ltd）注入瘫痪手臂的肱二头肌。在治疗前和治疗后2、4和6周，使用观察步态分析和其他主观评估量表评估患者的平衡和活动能力。治疗后AR显著减少，但临床医生评估，这似乎并未改善患者的平衡或活动性。有趣的是，七个八名患者报告改善他们的walking.Conclusion：观察到的治疗效果和报告之间的差异可能是由于在这项研究中使用的结果措施的敏感性差。
Purpose: The involuntary movements of the paretic arm during ambulation and other motor activities are known as associated upper limb reactions (ARs). ARs occur in 80% of stroke patients with spastic hemiplegia and often interfere with balance and safe mobilization. It is hypothesized that the treatment of localized muscle spasticity with botulinum toxin type A (BtxA) would abolish the ARs and improve balance and mobility.Method: This hypothesis will need to be tested in a randomized controlled trial (RCT). The aim of the present pilot study is to obtain preliminary data to inform the design of a future RCT. Eight patients received a single injection of 500 units of BtxA (Dysport(R) Ipsen, Ltd) into the biceps brachii of the paretic arm. The patients' balance and mobility were assessed before and 2, 4 and 6 weeks after treatment using observational gait analysis and other subjective assessment scales.Results: There was a significant reduction of the ARs after treatment but this did not appear to improve the patients' balance or mobility as assessed by the clinicians. Interestingly, seven out of the eight patients reported improvement in their walking.Conclusion: The discrepancy between the observed and reported effects of treatment could be due to the poor sensitivity of the outcome measures used in this study.