Modification of altered ankle motor control after stroke using focal application of Botulinum toxin type A Clinical Neurology and Neurosurgery, 05/02/2012

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

• 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.

• 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.