Effects of repeated injections of progressively higher doses of Botulinum Toxin on lower limbs of people with hyper-resistance after stroke on functional parameters of gait
(2022) PARIS Toxin Summit — Location: Paris (16.December.2022)
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- Background and aims This study assessed the cumulative effects of 3 injection cycles of increasing doses of Botulinum neurotoxin (BONT) on functional gait capacity (temporospatial parameters of gait : 1st and 2nd domains-ICF). The secondary outcome was to assess the effects on hyper-resistance (HR)(1st domain-ICF). Methods Thirty-two people with HR after chronic stroke underwent 3 BONT injection cycles with increasing total doses (400, 600 and 800 U) of Inco-BONT-A. Evaluation of walking capacity (6MWT, 10mWT, timed up the stairs test) were performed before and 1 month after each injection cycle for a total of 6 evaluations. Results RM-ANOVA showed improvements on the 6MWT (+27m after cycle 2, +43.8m after cycle 3), the 10mWT (-1.6s after cycle 2, -1.8s before cycle 3) and the time up and down the stairs test (-13.7s after cycle 2, -14.8s after cycle 3) (activities domain-ICF). Improvements were observed after the 2nd and 3rd cycle of injections, but not after the 1st one (p<0.05). Significant reduction of HR on specific muscle groups (plantar flexors, knee extended and flexed : reduction of 2 scores of the MAS after 3 cycles, p<0.001, knee extensors : reduction of 1 score at the MAS after 3 cycles, p=0.01) were observed after each injection cycle (body structure and functions domain-ICF). Conclusion This study showed more important effects of BONT on functional gait capacity after 3 cycles of progressively increasing doses, than after one cycle, thus suggesting cumulative effects of BONT injections and better effects of higher doses on lower limb function after stroke
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Selves, C., & et al. (2022). Effects of repeated injections of progressively higher doses of Botulinum Toxin on lower limbs of people with hyper-resistance after stroke on functional parameters of gait. PARIS Toxin Summit, Paris. https://hdl.handle.net/2078.5/28510