Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study.

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Serval ID
serval:BIB_D0DF910C5F8D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study.
Journal
Annals of physical and rehabilitation medicine
Author(s)
Baricich A., Picelli A., Carda S., Smania N., Cisari C., Santamato A., de Sire A., Invernizzi M.
ISSN
1877-0665 (Electronic)
ISSN-L
1877-0657
Publication state
Published
Issued date
07/2019
Peer-reviewed
Oui
Volume
62
Number
4
Pages
214-219
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
Botulinum toxin type A (BoNT-A) injection is an effective treatment for lower-limb spasticity and should be offered as first-line treatment for focal manifestations. Although its possible role has been hypothesized, the efficacy of electrical stimulation (ES) of antagonists of the injected muscles for improving clinical outcome after BoNT-A injection remains to be established.
This randomized single-blind pilot study aimed to investigate the efficacy of ES of antagonist muscles as adjunct treatment after BoNT-A injection to plantar flexor muscles in hemiplegic patients with spastic equinus foot.
After BoNT-A injection at triceps surae, patients were randomly allocated to 2 groups: group 1, single ES session on injected muscles plus 5 sessions of ES on antagonist muscles, and group 2, single ES session on injected muscles alone. Both groups underwent daily physical therapy for 60min for 2 weeks (5 days/week). Assessments were performed before treatment (T <sub>0</sub> ) and at 10 days (T <sub>1</sub> ), 20 days (T <sub>2</sub> ), and 90 days (T <sub>3</sub> ) after treatment. Our primary outcome was gait velocity at a comfortable speed at T <sub>2</sub> (10-m walk test [10MWT]). The following were secondary outcomes: triceps surae spasticity (Modified Ashworth Scale), ankle passive range of motion (pROM), strength of tibialis anterior muscle, and 2-min walk test (2MWT).
The 30 patients enrolled were randomly allocated to the 2 groups: 15 in group 1 and 15 in group 2. At T <sub>1</sub> , T <sub>2</sub> and T <sub>3</sub> , both groups showed a significant reduction in muscle tone and an increase in ankle pROM (P<0.05). At T <sub>2</sub> and T <sub>3</sub> , both groups showed a significant increase in 10MWT and 2MWT. The groups did not significantly differ in tibialis anterior strength or primary or secondary outcome measures.
ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection.
Keywords
Aged, Botulinum Toxins, Type A/therapeutic use, Combined Modality Therapy, Electric Stimulation Therapy, Equinus Deformity/drug therapy, Equinus Deformity/etiology, Equinus Deformity/therapy, Female, Hemiplegia/drug therapy, Hemiplegia/etiology, Hemiplegia/therapy, Humans, Leg, Male, Middle Aged, Muscle Spasticity/drug therapy, Muscle Spasticity/etiology, Muscle Spasticity/therapy, Neuromuscular Agents/therapeutic use, Physical Endurance, Pilot Projects, Recovery of Function, Single-Blind Method, Stroke, Stroke Rehabilitation, Treatment Outcome, Botulinum toxin type A, Electrical stimulation, Rehabilitation, Spasticity
Pubmed
Web of science
Open Access
Yes
Create date
15/07/2019 17:18
Last modification date
15/07/2020 6:22
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