Effects of botulinum toxin type A for spastic foot in
          post-stroke patients enrolled in a rehabilitation program

Pimentel, Leonardo Halley Carvalho; Alencar, Francisco José; Rodrigues, Leonardo Raphael Santos; Sousa, Francisca Cléa Florenço de; Teles, João Batista Mendes

doi:10.1590/0004-282X20130189

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Articles • Arq. Neuro-Psiquiatr. 72 (1) • Jan 2014 • https://doi.org/10.1590/0004-282X20130189 copy

Effects of botulinum toxin type A for spastic foot in post-stroke patients enrolled in a rehabilitation program

Efeitos da toxina botulínica tipo A no pé espástico em pacientes pós-acidente vascular encefálico inseridos em programa de reabilitação

Authorship SCIMAGO INSTITUTIONS RANKINGS

The objective of this study was to evaluate the effects of botulinum toxin type A (BTX-A) on spastic foot in stroke patients in a rehabilitation program.

Method:

Hemiparetic stroke patients (n=21) enrolled in a rehabilitation program were divided into two groups. The first group (n=11) received a total of 300UI BTX-A, and the second group (n=10) received 100 UI BTX-A. All patients were assessed at baseline and 2, 4, 8 and 12 weeks after injection for Modified Ashworth Score, time walking 10 meters, and the Functional Independence Measure (mFIM) motor score.

Results:

The higher-dose group exhibited a significant improvement in spasticity, and both groups showed an improvement in time walking 10 meters and mFIM, with no significant differences between them.

Conclusions:

Our findings suggest that gains in gait velocity and functional independence were not correlated to BTX-A dose.

botulinum toxin type A; stroke; spasticity

Variables (SD)	Group 1 (n=11)	Group 2 (n=10)	p-value (two-tailed)
Mean age in years	50.5 (±6.8)	47.9 (±3.8)	0.309
Median	51	48
[Range]	[34-59]	[42-54]
Gender			0.395
Female	7	4
Male	4	6
Mean time since stroke in months	41.6 (±63.4)	34.5 (±33.8)	0.721
Median	11	16
[Range]	[ ⁶6 . Ozcakir S, Sivrioglu K. Botulinum toxin in post-stroke spasticity. Clin Med Res 2007;5:132-138. -193]	[6-89]
Stroke type			1.000
Ischemic	7	7
Hemorrhagic	4	3
Hemiparesis side			0.670
Right	5	6
Left	6	4
Mean time walking 10 meters before BTX-A	35.7 (±7.3)	34.9 (±6.1)	0.782
Median	34	33.5
[Range]	[27-48]	[28-45]
Mean mFIM before BTX-A	65.3 (±15.1)	70.0 (±9.4)	0.406
Median	69	68
[Range]	[41-88]	[61-86]

Variables	Baseline		2 weeks		4 weeks		8 weeks		12 weeks
Mean (SD)	Group 1	Group 2	Group 1	Group 2	Group 1	Group 2	Group 1	Group 2	Group 1	Group 2
Modified ashworth score	3.3 (±0.5)	3.4 (±0.5)	3.0 (±0.8)	3.3 (±0.7)	2.0 (±1.0)	2.7 (±0.8)	1.7 (±0.8)	2.7 (±0.8)	1.6 (±0.9)	3.3 (±0.7)
Time walking 10 meters	35.73 (±7.29)	34.90 (±6.06)	35.82 (±7.49)	34.90 (±6.30)	35.09 (±6.76)	32.80 (±6.53)	31.18 (±7.01)	31.00 (±5.50)	30.82 (±7.18)	31.90 (±5.63)
mFIM	65.27 (±15.10)	70.00 (±9.39)	66.82 (±15.48)	72.30 (±9.71)	69.73 (±15.59)	74.10 (±8.75)	72,82 (±15.57)	76.30 (±9.36)	75.09 (±14.90)	77.90 (±10.06)

	Ashworth score		Time walking 10 m		mFIM
	t	p-value	t	p-value	t	p-value
Baseline	-0.593	0.560	0.281	0.782	-0.851	0.406
Week 2	-1.533	0.358	0.302	0.766	-0.960	0.349
Week 4	-1.711	0.098	0.788	0.440	-0.781	0.444
Week 8	-2.616	0.012*	0.066	0.948	-0.613	0.547
Week 12	-5.318	0.0001*	-0.381	0.707	-0.501	0.622

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[1] Correspondence: Leonardo Halley Carvalho Pimentel; Avenida Higino Cunha 1515; 64014-220 Teresina PI - Brasil; E-mail: leonardo.pimentel@ceir.org.br