BOTULINUM TOXIN TYPE A (BoNT-A) EFFECTS ON GAIT IN STROKE PATIENTS WITH SPASTIC HEMIPARESIS

YANAGISAWA Shimako, KAWATE Nobuyuki, MIZUMA Masazumi

doi:10.14930/jshowaunivsoc.76.346

In this study, we evaluated changes in spastic gait after injection of botulinum toxin type A (BoNT-A) with an objective instrument. The subjects were 16 stroke patients. In total, 200-300 units of BoNT-A were injected into the spastic muscles in the affected lower leg of each patient. Each subject's gait was evaluated before and one month after the treatment by means of gait analysis employing a foot pressure measurement system with a sheet sensor. The measurements included gait speed and proportions of stance (St), swing (Sw), and double support (Ds) in the gait cycle. Based on the changes in gait speed after treatment, the subjects were divided into decreased gait speed (n=7) and increased gait speed (n=9) groups. The proportions of St, Sw, and Ds phases in the gait cycle were compared between the two groups. In the performance analysis for the affected legs, the decreased speed gait group exhibited an increase in St, decrease in Sw, and increase in Ds, while the increased gait speed group exhibited a decrease in St, increase in Sw, and decrease in Ds. We consider the decreased gait speed to be attributable to the loss of stable support resulting from their spastic legs due to an acute reduction of spasticity with BoNT-A. Our results suggest that objective instrumental evaluation is useful for in-depth evaluation of the effects of BoNT-A and it provides useful information for planning rehabilitation regimens.

BOTULINUM TOXIN TYPE A (BoNT-A) EFFECTS ON GAIT IN STROKE PATIENTS WITH SPASTIC HEMIPARESIS

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