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Effetsdetroiscyclesdedosesprogressivementcroissantesdetoxinebotuliniquesurdesparamètrescinématiquessagittauxde.pdf
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Abstract
Objective : Gait kinematic analysis is essential for evaluating walking quality and efficacy of interventions. Spastic gait varies among individuals, even when they present similar postural gait patterns or muscle involvement. While previous studies have reported functional gait improvements following repeated botulinum toxin-A (BT-A) injections, effects on gait kinematics remain unclear. This study investigates kinematic changes in the sagittal plane at the ankle and knee joints, which were the primary treatment targets, after three cycles of progressively higher BT-A injections. Material / Patients and Methods : This prospective cohort study assessed gait kinematics in adults with chronic stroke-related spasticity affecting multiple lower limb segments, who received three cycles of progressively higher doses of Inco BT-A (400, 600, and 800 U). Quantified gait analysis (QGA) was performed before treatment and after the first and last injection cycles to assess kinematic changes. To account for inter-individual variability, we identified kinematic variables that best reflected individual postural gait patterns. Results : Twenty-five participants were included in this study. Kinematic improvements were not observed after the first injection cycle but became apparent after the third. Significant improvements were observed in two postural gait patterns: pes equinus, with a mean increase in ankle dorsiflexion during stance of 3° (SD = 6°, p = 0.008), and stiff knee gait, with a mean increase in knee flexion during swing of 7° (SD = 7°, p < 0.001). Discussion - Conclusion : This study showed effects of progressively higher doses of BT-A on sagittal knee and ankle kinematics in individuals with lower limb spasticity after chronic stroke, suggesting that three cycles of progressively higher doses are necessary to achieve measurable kinematic improvements. These results align with functional gains from our larger study, underscoring the importance of individualized gait assessments in clinical decision-making on post-stroke spastic gait.
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Selves, C., Stoquart, G., Lejeune, T., Deltombe, T., & Dehem, S. (2025). Effets de trois cycles de doses progressivement croissantes de toxine botulinique sur des paramètres cinématiques sagittaux de marche chez des personnes présentant une spasticité multifocale après AVC : une étude prospective de cohorte. SOFMER 2025, Strasbourg. https://hdl.handle.net/2078.5/270923