Modification of altered ankle motor control after stroke using focal application of Botulinum toxin type A

Clinical Neurology and Neurosurgery, 05/02/2012

Botulinum toxin type A (BTX–A) is effective in reducing antagonistic and distant muscle activation that impedes volitional dorsiflexion.

Methods

  • 15 post-stroke and 10 matched neurologically intact subjects.
  • Modified Ashworth Scale (MAS) and Fugl–Meyer assessment of physical function scale scores along with surface EMG collected before and up to 12weeks after BTX-A injections to plantar flexor muscle motor points in stroke subjects.
  • Saline placebo injections were performed in a subset of stroke subject group.

Results

  • MAS scores were decreased at 4, 8 and 12weeks but F–M scores did not improve until 12weeks post injection.
  • Multi-muscle EMG patterns showed the return of volitional dorsiflexor activity in 11 and a decrease of antagonistic and distant coactivation in all but one of the 15.

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