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Botulinum toxin gait

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https://www.readbyqxmd.com/read/29150297/prolonged-stretching-of-the-ankle-plantarflexors-elicits-muscle-tendon-adaptations-relevant-to-ankle-gait-kinetics-in-children-with-spastic-cerebral-palsy
#1
Teresa Martín Lorenzo, Eduardo Rocon, Ignacio Martínez Caballero, Ana Ramírez Barragán, Sergio Lerma Lara
Tissue related ankle hyper-resistance has been reported to contribute to equinus gait in children with spastic cerebral palsy. Hence, ankle plantarflexor stretching programs have been developed in order to restore passive ankle dorsiflexion. Despite high quality evidence on the limited effects of stretching on passive joint mobility, further muscle-tendon adaptations have been reported which may impact gait performance. As such, children with spastic cerebral palsy subject to long-term manual static stretching achieved dorsiflexion gains through the reduction of muscle and fascicle strain whilst preserving tendon strain, and prolonged use of ankle-foot orthoses achieved similar dorsiflexion gains through increased tendon strain whilst preserving muscle and fascicle strain...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29133972/the-relationship-between-the-physical-cost-index-and-knee-extensor-strength-in-children-with-hemiplegic-cerebral-palsy
#2
Kenji Takaki, Yasuaki Kusumoto
[Purpose] Lower extremity strength is a contributing factor to energy efficiency of gait. However, this contribution has not previously been evaluated in children with hemiplegic cerebral palsy (CP). The aim of this study was to evaluate the association between energy consumption, measured by the physical cost index (PCI), and strength of lower extremity, measured by the maximum knee extensor strength (MKES), in children with hemiplegic CP. [Subjects and Methods] Subjects were 10 children (4 males and 6 females; age, 7-17 years) with hemiplegic CP, but no history of orthopedic intervention or botulinum toxin treatment over the 1 year prior to the assessment...
October 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/29116170/injection-of-high-dose-botulinum-toxin-a-leads-to-impaired-skeletal-muscle-function-and-damage-of-the-fibrilar-and-non-fibrilar-structures
#3
Jessica Pingel, Mikkel Schou Nielsen, Torsten Lauridsen, Kristian Rix, Martin Bech, Tine Alkjaer, Ida Torp Andersen, Jens Bo Nielsen, R Feidenhansl
Botulinum-toxin A (BoNT/A) is used for a wide range of conditions. Intramuscular administration of BoNT/A inhibits the release of acetylcholine at the neuromuscular junction from presynaptic motor neurons causing muscle-paralysis. The aim of the present study was to investigate the effect of high dose intramuscular BoNT/A injections (6 UI = 60 pg) on muscle tissue. The gait pattern of the rats was significantly affected 3 weeks after BoNT/A injection. The ankle joint rotated externally, the rats became flat footed, and the stride length decreased after BoNT/A injection...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28855162/muscle-paralysis-induces-bone-marrow-inflammation-and-predisposition-to-formation-of-giant-osteoclasts
#4
Brandon J Ausk, Leah E Worton, Kate S Smigiel, Ronald Y Kwon, Steven D Bain, Sundar Srinivasan, Edith M Gardiner, Ted S Gross
Transient muscle paralysis engendered by a single injection of botulinum toxin A (BTxA) rapidly induces profound focal bone resorption within the medullary cavity of adjacent bones. While initially conceived as a model of mechanical disuse, osteoclastic resorption in this model is disproportionately severe compared to the modest gait defect that is created. Preliminary studies of bone marrow following muscle paralysis suggested acute upregulation of inflammatory cytokines, including TNF and IL-1. We therefore hypothesized that BTxA-induced muscle paralysis would rapidly alter the inflammatory microenvironment and the osteoclastic potential of bone marrow...
August 30, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/28837826/botulinum-toxin-in-parkinsonism-the-when-how-and-which-for-botulinum-toxin-injections
#5
Francisco Cardoso
The aim of this article is to provide a review of the use of injections of botulinum toxin in the management of selected symptoms and signs of Parkinson's disease and other forms of parkinsonism. Sialorrhea is defined as inability to control oral secretions, resulting in excessive saliva in the oropharynx. There is a high level of evidence for the treatment of sialorrhea in parkinsonism with injections of different forms of botulinum toxin type A as well as botulinum toxin type B. Tremor can be improved by the use of botulinum toxin injections but improved tremor control often leads to concomitant motor weakness, limiting its use...
August 23, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28834868/outcomes-of-intrathecal-baclofen-therapy-in-patients-with-cerebral-palsy-and-acquired-brain-injury
#6
Young Kwon Yoon, Kil Chan Lee, Han Eol Cho, Minji Chae, Jin Woo Chang, Won Seok Chang, Sung-Rae Cho
Intrathecal baclofen (ITB) has been known to reduce spasticity which did not respond to oral medications and botulinum toxin treatment. However, few results have been reported comparing the effects of ITB therapy in patients with cerebral palsy (CP) and acquired brain injury. This study aimed to investigate beneficial and adverse effects of ITB bolus injection and pump therapy in patients with CP and to compare outcomes to patients with acquired brain injury such as traumatic brain injury and hypoxic brain injury...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28825663/efficacy-of-repeated-botulinum-toxin-type-a-injections-for-spastic-equinus-in-children-with-cerebral-palsy-a-secondary-analysis-of-the-randomized-clinical-trial
#7
Bo Young Hong, Hyun Jung Chang, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
Botulinum toxin A is considered an important tool to control spasticity in children with cerebral palsy. Several factors are known to affect the efficacy of botulinum toxin, such as dosage, appropriate muscle selection and application, age, and accompanying therapy. A multicenter, double-blind, randomized, prospective phase III clinical trial of botulinum toxin A for the treatment of dynamic equinus in 144 children with cerebral palsy was performed to compare the efficacies of letibotulinumtoxin A and onabotulinumtoxin A...
August 21, 2017: Toxins
https://www.readbyqxmd.com/read/28735160/longitudinal-assessment-of-gait-quality-in-children-with-bilateral-cerebral-palsy-following-repeated-lower-limb-intramuscular-botulinum-toxin-a-injections
#8
Felicity A Read, Roslyn N Boyd, Lee A Barber
BACKGROUND: Serial lower limb intramuscular Botulinum toxin-A (BoNT-A) injections are administered to children with bilateral spastic cerebral palsy (BCP) to reduce spasticity, improve walking and functional mobility, and delay the need for orthopaedic surgery. Gait quality is clinically assessed following BoNT-A with 2D video gait assessments (2DVGA) using the Edinburgh Visual Gait Score (EVGS). AIM: To determine the effect of three consecutive treatment cycles of lower limb intramuscular BoNT-A injections on gait quality using the EVGS in children with BCP by retrospectively reviewing repeated 2DVGA measures...
July 20, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/28712731/cervical-dystonia-patients-display-subclinical-gait-changes
#9
Marcello Esposito, Raffaele Dubbioso, Silvio Peluso, Antonio Picone, Bruno Corrado, Clemente Servodio Iammarone, Roberto Allocca, Fiore Manganelli, Lucio Santoro, Alfonso Fasano
INTRODUCTION: Gait disorders in cervical dystonia (CD) are reported in patients under DBS or in severe cases complicated with spinal deformities. OBJECTIVE: to assess walking motor pattern in CD patients without DBS and not presenting scoliosis. METHODS: Computerized gait analysis (CGA) was performed in CD patients, before and after botulinum toxin (BoNT) injections, and in healthy controls (HC). Spatiotemporal (ST) parameters were compared between CD and HC groups...
July 10, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28520679/knee-recurvatum-in-children-with-spastic-diplegic-cerebral-palsy
#10
Jeremy Bauer, K Patrick Do, Jing Feng, Rosemary Pierce, Michael Aiona
BACKGROUND: The purpose of this study is to determine which factors drive patients with diplegic cerebral palsy to walk without knee recurvatum despite hyperextension of the knee on physical examination. METHODS: A retrospective review was conducted of all data collected in the Gait Analysis Laboratory between 1999 and 2014. Patients with spastic diplegic cerebral palsy and at least 5 degrees of knee extension on clinical examination were identified for the study...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28481738/outcomes-of-botulinum-toxin-type-a-for-equinovarus-deformity-in-patients-with-cva-a-case-series
#11
Priya Karakkattil, Elaine Trudelle-Jackson, Heather Hilliard Brown, Patrick Hammontree, Mary Okolo
BACKGROUND: There is evidence that Botulinum Toxin-A (BTX-A) reduces focal spasticity associated with equinovarus to improve gait in patients poststroke. However, there is little research examining whether gait improvements are maintained after the effectiveness period of BTX-A injections. The purpose of this observational study was to determine whether there was a difference in gait parameters in three patients before BTX-A injection versus four and ten weeks after. CASE SERIES: Three women, ages 63, 60, and 42 postischemic stroke with hemiparesis and equinovarus underwent measurements for: plantar flexor spasticity, ankle dorsiflexion ROM, temporal-spatial gait parameters, and gait endurance...
May 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28279852/effectiveness-of-surgical-and-non-surgical-management-of-crouch-gait-in-cerebral-palsy-a-systematic-review
#12
REVIEW
Scott A Galey, Zachary F Lerner, Thomas C Bulea, Seymour Zimbler, Diane L Damiano
BACKGROUND: Cerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP...
February 24, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28272726/-measurement-of-the-outcomes-in-acquired-brain-injury-in-a-neurorehabilitation-unit-a-long-term-study
#13
V Cruz-Guisado, P Diaz-Borrego, B Romero-Romero, M Rodriguez-Pinero Duran
INTRODUCTION: Following sudden brain damage, there is a loss of capabilities that affects the person's autonomy. Recovery from the physical, psychic and cognitive sequelae requires the application of multiple therapies, the outcomes of which need to be measured objectively. Our aim is to analyse the application of standardised instruments in determining the therapeutic outcomes in acquired brain injury. PATIENTS AND METHODS: We conducted a retrospective descriptive observational study lasting 13 months...
March 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28187305/improvement-of-upper-trunk-posture-during-walking-in-hemiplegic-patients-after-injections-of-botulinum-toxin-into-the-arm
#14
Harald Hefter, Dietmar Rosenthal
BACKGROUND: It has been hypothesized that altered trunk movements during gait in post-stroke patients or children with cerebral palsy are compensatory to lower limb impairment. Improvement of trunk movements and posture after injections of botulinum toxin into the affected arm would be at variance with this hypothesis and hint towards a multifactorial trunk control deficit. PATIENTS AND METHODS: Clinical gait analysis was performed in 11 consecutively recruited hemiplegic patients immediately before and 4weeks after a botulinum toxin type A-injection into the affected arm...
March 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28092243/-botulinum-toxin-a-and-physical-therapy-in-gait-in-cerebral-palsy
#15
Sandra Fabiola García-Sánchez, María Teresa Gómez-Galindo, Jaime Eduardo Guzmán-Pantoja
BACKGROUND: Cerebral palsy (PCI) is the leading cause of disability in children. Botulinum toxin type A (TBA) is a treatment to improve the function and pattern in the gait, although with a few studies that quantify the improvement. METHODS: Quasi-experimental study was conducted from May 2010 to September 2011, in Integrated Rehabilitation Center, in 36 patients with spastic PCI. Was evaluated: functionality of travel by the scale of Koman, speed of the gait with tone scale of Ashworth and arches of passive mobility, were applied TBA and was sent to 10 sessions of physical therapy, with measurements taken before, the 1st and 4th month...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28024228/vector-field-statistics-for-the-analysis-of-time-varying-clinical-gait-data
#16
C J Donnelly, C Alexander, T C Pataky, K Stannage, S Reid, M A Robinson
BACKGROUND: In clinical settings, the time varying analysis of gait data relies heavily on the experience of the individual(s) assessing these biological signals. Though three dimensional kinematics are recognised as time varying waveforms (1D), exploratory statistical analysis of these data are commonly carried out with multiple discrete or 0D dependent variables. In the absence of an a priori 0D hypothesis, clinicians are at risk of making type I and II errors in their analyis of time varying gait signatures in the event statistics are used in concert with prefered subjective clinical assesment methods...
January 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/27987468/neurotomy-of-the-rectus-femoris-nerve-short-term-effectiveness-for-spastic-stiff-knee-gait-clinical-assessment-and-quantitative-gait-analysis
#17
R Gross, J Robertson, F Leboeuf, O Hamel, S Brochard, B Perrouin-Verbe
BACKGROUND: Stiff knee gait is a troublesome gait disturbance related to spastic paresis, frequently associated with overactivity of the rectus femoris muscle in the swing phase of gait. OBJECTIVE: The aim of this study was to assess the short-term effects of rectus femoris neurotomy for the treatment of spastic stiff-knee gait in patients with hemiparesis. PATIENTS AND METHODS: An Intervention study (before-after trial) with an observational design was carried out in a university hospital...
November 19, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27907934/restriction-of-postoperative-joint-loading-in-a-murine-model-of-anterior-cruciate-ligament-reconstruction-botulinum-toxin-paralysis-and-external-fixation
#18
Amir Lebaschi, Xiang-Hua Deng, Nathan W Coleman, Christopher L Camp, Jianchun Zong, Andrew Carbone, Camila B Carballo, Guang-Ting Cong, Zoe M Album, Scott A Rodeo
Control of knee motion in small animal models is necessary to study the effect of mechanical load on the healing process. This can be especially challenging in mice, which are being increasingly used for various orthopedic reconstruction models. We explored the feasibility of botulinum toxin (Botox; Allergan, Dublin, Ireland) paralysis and a newly designed external fixator to restrict motion of the knee in mice undergoing anterior cruciate ligament (ACL) reconstruction. Nineteen C57BL/6 mice were allocated to two groups: (1) Botox group (n = 9) and (2) external fixator group (n = 10)...
September 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27861211/what-s-new-in-the-management-of-foot-deformities-in-children-with-cerebral-palsy
#19
John A Heydemann, Oussama Abousamra, Jeanne M Franzone, Brian E Kaufman, Julieanne P Sees
BACKGROUND: Foot deformities have been frequently reported in cerebral palsy (CP), and numerous diagnostic modalities and treatment options have recently been developed to achieve a better level of management for children with CP. METHODS: A thorough search of the English literature, published between January 2013 and March 2016, was performed. A summary of the new findings that had not previously described was reported. The review included recent advances regarding clinical and gait evaluation, orthotic management, botulinum toxin A treatment, and surgical correction...
November 17, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27677011/correction-of-hip-internal-rotation-in-walking-cerebral-palsy-adolescent-using-a-soft-tissue-procedure-an-alternative-to-femoral-rotation-osteotomy
#20
Bruno Dohin, Elie Haddad, Hassan Al Khoury Salem, Mohamed Merhez Kilani
OBJECTIVE: Hip internal rotation (HIR) during gait is one of the main functional disorders related to cerebral palsy (CP) in children. Most of the procedures proposed rotational osteotomy of the femur (FRO), (and/or tibia). However, multilevel surgery (SEMLS) including bone procedure, implicates more difficult and longer rehabilitation. When bone deformity is moderate, the authors hypothesized that FRO could be avoided. They developed a soft tissues procedure to improve HIR. The aim of the study was assessment of the procedure...
September 2016: Annals of Physical and Rehabilitation Medicine
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