Cargando…

Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study

Equinovarus/equinus foot is a pattern most commonly treated with botulinum toxin type A in patients with post-stroke spasticity involving the lower limbs; the gastrocnemius is the muscle most frequently injected. Spastic equinovarus/equinus can present a mixture of conditions, including spasticity,...

Descripción completa

Detalles Bibliográficos
Autores principales: Picelli, Alessandro, Filippetti, Mirko, Melotti, Camilla, Guerrazzi, Flavio, Modenese, Angela, Smania, Nicola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764832/
https://www.ncbi.nlm.nih.gov/pubmed/33327423
http://dx.doi.org/10.3390/toxins12120797
_version_ 1783628350534713344
author Picelli, Alessandro
Filippetti, Mirko
Melotti, Camilla
Guerrazzi, Flavio
Modenese, Angela
Smania, Nicola
author_facet Picelli, Alessandro
Filippetti, Mirko
Melotti, Camilla
Guerrazzi, Flavio
Modenese, Angela
Smania, Nicola
author_sort Picelli, Alessandro
collection PubMed
description Equinovarus/equinus foot is a pattern most commonly treated with botulinum toxin type A in patients with post-stroke spasticity involving the lower limbs; the gastrocnemius is the muscle most frequently injected. Spastic equinovarus/equinus can present a mixture of conditions, including spasticity, muscle/tendon shortening, muscle weakness and imbalance. In this study, we wanted to determine whether botulinum toxin treatment affects the ultrasonographic characteristics of post-stroke spastic equinus. The same dose of AbobotulinumtoxinA was injected into the gastrocnemius medialis and lateralis of 21 chronic stroke patients with spastic equinus. Clinical (Ashworth scale and ankle range of motion) and ultrasound (conventional and sonoelastography) evaluation of the treated leg was carried out before and 4 weeks after injection. No significant effects of botulinum toxin treatment on the ultrasonographic characteristics of spastic equinus were observed. As expected, there were significant improvements in ankle passive dorsiflexion range of motion and calf muscle spasticity at 1 month after treatment. There was a direct association between Achilles tendon elasticity and calf muscle spasticity at baseline evaluation. Larger studies with a long-term timeline of serial evaluations are needed to further investigate the possible effects of botulinum toxin injection on spastic muscle characteristics in patients with post-stroke spasticity.
format Online
Article
Text
id pubmed-7764832
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-77648322020-12-27 Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study Picelli, Alessandro Filippetti, Mirko Melotti, Camilla Guerrazzi, Flavio Modenese, Angela Smania, Nicola Toxins (Basel) Communication Equinovarus/equinus foot is a pattern most commonly treated with botulinum toxin type A in patients with post-stroke spasticity involving the lower limbs; the gastrocnemius is the muscle most frequently injected. Spastic equinovarus/equinus can present a mixture of conditions, including spasticity, muscle/tendon shortening, muscle weakness and imbalance. In this study, we wanted to determine whether botulinum toxin treatment affects the ultrasonographic characteristics of post-stroke spastic equinus. The same dose of AbobotulinumtoxinA was injected into the gastrocnemius medialis and lateralis of 21 chronic stroke patients with spastic equinus. Clinical (Ashworth scale and ankle range of motion) and ultrasound (conventional and sonoelastography) evaluation of the treated leg was carried out before and 4 weeks after injection. No significant effects of botulinum toxin treatment on the ultrasonographic characteristics of spastic equinus were observed. As expected, there were significant improvements in ankle passive dorsiflexion range of motion and calf muscle spasticity at 1 month after treatment. There was a direct association between Achilles tendon elasticity and calf muscle spasticity at baseline evaluation. Larger studies with a long-term timeline of serial evaluations are needed to further investigate the possible effects of botulinum toxin injection on spastic muscle characteristics in patients with post-stroke spasticity. MDPI 2020-12-14 /pmc/articles/PMC7764832/ /pubmed/33327423 http://dx.doi.org/10.3390/toxins12120797 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Picelli, Alessandro
Filippetti, Mirko
Melotti, Camilla
Guerrazzi, Flavio
Modenese, Angela
Smania, Nicola
Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study
title Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study
title_full Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study
title_fullStr Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study
title_full_unstemmed Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study
title_short Does Botulinum Toxin Treatment Affect the Ultrasonographic Characteristics of Post-Stroke Spastic Equinus? A Retrospective Pilot Study
title_sort does botulinum toxin treatment affect the ultrasonographic characteristics of post-stroke spastic equinus? a retrospective pilot study
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764832/
https://www.ncbi.nlm.nih.gov/pubmed/33327423
http://dx.doi.org/10.3390/toxins12120797
work_keys_str_mv AT picellialessandro doesbotulinumtoxintreatmentaffecttheultrasonographiccharacteristicsofpoststrokespasticequinusaretrospectivepilotstudy
AT filippettimirko doesbotulinumtoxintreatmentaffecttheultrasonographiccharacteristicsofpoststrokespasticequinusaretrospectivepilotstudy
AT melotticamilla doesbotulinumtoxintreatmentaffecttheultrasonographiccharacteristicsofpoststrokespasticequinusaretrospectivepilotstudy
AT guerrazziflavio doesbotulinumtoxintreatmentaffecttheultrasonographiccharacteristicsofpoststrokespasticequinusaretrospectivepilotstudy
AT modeneseangela doesbotulinumtoxintreatmentaffecttheultrasonographiccharacteristicsofpoststrokespasticequinusaretrospectivepilotstudy
AT smanianicola doesbotulinumtoxintreatmentaffecttheultrasonographiccharacteristicsofpoststrokespasticequinusaretrospectivepilotstudy