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Botulinum toxin gait

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https://www.readbyqxmd.com/read/29771161/casting-protocols-following-bont-a-injections-to-treat-spastic-hypertonia-of-the-triceps-surae-in-children-with-cerebral-palsy-and-equinus-gait-a-randomized-controlled-trial
#1
Barbara Kelly, Marilyn MacKay-Lyons, Susan Berryman, Joe Hyndman, Ellen Wood
AIM: To study the effects of single versus serial casting post-Botulinum toxin A (BoNT-A) injections on hypoextensibility of triceps surae in children, 2-7 years old, with cerebral palsy and equinus gait. METHODS: A randomized, stratified, parallel, two-group trial was conducted at a pediatric health center with assessments at baseline, precast, postcast and, 1-, 2-, and 6-month follow-ups. One week following BoNT-A injections into triceps surae muscle, a single below-knee cast (n = 10) or 3 serial casts (n = 10) were applied for 3 weeks...
May 17, 2018: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/29765892/botulinum-toxin-a-injection-in-the-treatment-of-spasticity-in-a-infantile-onset-neurodegeneration-with-brain-iron-accumulation-a-case-report
#2
Hwan Kwon Do, Geun Yeol Jo, Jun Koo Kwon, Woo Jin Kim
Pantothenate kinase-associated neurodegeneration (PKAN) is a neurodegenerative disorder characterized by iron accumulation in the globus pallidus (GP) of the brain (neurodegeneration with brain iron accumulation [NBIA]), which is characterized by dystonia and spasticity resulting in postural difficulties. A 33-month-old boy was admitted with a pronounced gait disturbance. Marked hypertonicity in the patient's both calf muscles was noted, resulting in waddling with repeated slip-falls. NBIA was suspected by high T2 intensity in the GP on brain MRI, then it was confirmed by detecting PANK2 mutation...
April 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29677101/electromyographic-and-joint-kinematic-patterns-in-runner-s-dystonia
#3
Omar F Ahmad, Pritha Ghosh, Christopher Stanley, Barbara Karp, Mark Hallett, Codrin Lungu, Katharine Alter
Runner’s dystonia (RD) is a task-specific focal dystonia of the lower limbs that occurs when running. In this retrospective case series, we present surface electromyography (EMG) and joint kinematic data from thirteen patients with RD who underwent instrumented gait analysis (IGA) at the Functional and Biomechanics Laboratory at the National Institutes of Health. Four cases of RD are described in greater detail to demonstrate the potential utility of EMG with kinematic studies to identify dystonic muscle groups in RD...
April 20, 2018: Toxins
https://www.readbyqxmd.com/read/29664850/idiopathic-toe-walking-prevalence-and-natural-history-from-birth-to-ten-years-of-age
#4
Pähr Engström, Kristina Tedroff
BACKGROUND: Children with idiopathic toe-walking, a common pediatric condition, walk some or all of the time on their toes. This condition often causes parental concern, with repeated medical contacts and a range of interventions including stretching, casts, injection of botulinum toxin A, and surgical procedures. The purpose of this cohort study was to document the natural history of this condition. METHODS: In a population-based cohort of 1,401 healthy 5.5-year-old Swedish children, we found the prevalence of idiopathic toe-walking to be approximately 5% (63 of 1,401)...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29649706/quantitative-assessment-for-flexed-elbow-deformity-during-gait-following-botulinum-toxin-a-treatment
#5
Hiroki Tanikawa, Hitoshi Kagaya, Keisuke Inagaki, Yusuke Kotsuji, Keita Suzuki, Kenta Fujimura, Masahiko Mukaino, Satoshi Hirano, Eiichi Saitoh, Yoshikiyo Kanada
BACKGROUND: The effect of botulinum toxin A (BoNTA) injection on flexed-elbow deformity is usually evaluated using the Modified Ashworth Scale (MAS), but only with the muscle tone at rest. Some patients show the flexed-elbow deformity during gait despite low muscle tone at rest. OBJECTIVE: This study aimed to evaluate the effect of BoNTA injection on flexed-elbow deformity during gait using a three-dimensional motion analysis system. METHODS: Twenty stroke patients with spastic flexed-elbow deformity during gait received BoNTA injections into the upper limb muscles...
April 6, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29610039/botulinum-toxin-type-a-treatment-combined-with-intensive-rehabilitation-for-gait-poststroke-a-preliminary-study
#6
Yuki Uchiyama, Tetsuo Koyama, Yosuke Wada, Masashi Katsutani, Norihiko Kodama, Kazuhisa Domen
GOAL: To examine the effects of botulinum toxin type A (BoNT-A) treatment combined with intensive rehabilitation for gait compared with intensive rehabilitation alone in patients with chronic stroke. MATERIALS AND METHODS: A comparative case series design was used. Subjects were 19 patients with chronic stroke and spastic hemiplegia. In 9 patients (group I), BoNT-A was injected into spastic muscles of the affected lower limbs, followed by a 4-week inpatient intensive rehabilitation program...
March 30, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29578189/effect-of-multilevel-lower-limb-botulinum-injections-intensive-physical-therapy-on-children-with-cerebral-palsy
#7
Monica Juneja, Rahul Jain, Ankita Gautam, Ritu Khanna, Kamia Narang
Background & objectives: Botulinum toxin is considered as an effective treatment for spasticity in children with cerebral palsy (CP). However, there are only a few long-term studies, and the effects on motor function have been inconclusive. Moreover, due to its high cost and need for intensive post-injection therapy, utility in context of developing nations has not been established. This retrospective study was undertaken to assess the long term effects of botulinum toxin-A with physical therapy in children with CP...
November 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29571089/long-term-gait-outcomes-following-conservative-management-of-idiopathic-toe-walking
#8
Karen Davies, Alec Black, Michael Hunt, Liisa Holsti
BACKGROUND: Idiopathic toe walking is a diagnosis of exclusion characterized by a persistent toe-toe gait pattern after three years of age. Treatment for toe walking includes physical therapy, orthotics, casting, Botulinum Toxin A injection into gastrocnemius/soleus muscles, and/or surgery; yet, little evidence exists regarding long-term treatment effects. RESEARCH QUESTION: The objective of this study was to explore the differences in longer-term gait outcomes and severity of idiopathic toe walking between children treated actively with casting or inactively following recommendations for stretching...
February 14, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29530514/functional-outcomes-following-ultrasound-guided-botulinum-toxin-type-a-injections-to-reduce-spastic-equinovarus-in-adult-post-stroke-patients
#9
Semra Aktürk, Raikan Büyükavcı, Yüksel Ersoy
OBJECTIVE: The aim of this study is to identify the effect on spasticity and walking of US-guided botulinum toxin type A (BoNT-A) injections administered to improve equinovarus walking pattern commonly observed in patients after stroke. MATERIAL AND METHOD: Twenty-three patients with post-stroke spastic equinovarus deformity were recruited. The US-guided BoNT-A injections were administered into the spastic muscles (including gastrocnemius; GK, soleus; S and tibialis posterior; TP) using a specific approach, and all of the patients were enrolled in rehabilitation programmes after the injections...
May 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29510955/effect-of-botulinum-toxin-type-a-treatment-in-children-with-cerebral-palsy-sequential-physical-changes-for-3-months-after-the-injection
#10
Mayumi Matsuda, Kazuhide Tomita, Arito Yozu, Tomohiro Nakayama, Jyunko Nakayama, Haruka Ohguro, Nobuaki Iwasaki
PURPOSE: This study investigated the sequential physical changes after botulinum toxin type A (BTX-A) injected in children with cerebral palsy. METHODS: Nine children with cerebral palsy were included. Measurements were performed before treatment and 4 weeks, 8 weeks, and 12 weeks after treatment. We used video-recorded gait in the sagittal plane. The maximum flexion and extension angles of the hip, knee and ankle joints, step length, gait speed, and observational gait were measured using the Foot Contact Scale (FCS) and the Physician's Rating Scale (PRS)...
June 2018: Brain & Development
https://www.readbyqxmd.com/read/29510234/the-effects-of-botulinum-toxin-injections-on-plantar-flexor-spasticity-in-different-phases-after-stroke-a-secondary-analysis-from-a-double-blind-randomized-trial
#11
Hyun-Mi Oh, Geun-Young Park, Young Min Choi, Hyung Jung Koo, Yongjun Jang, Sun Im
BACKGROUND: There are no guidelines on the ideal time to inject botulinum toxin type A (BT-A) for lower leg spasticity in stroke patients. An early injection may produce unwanted weakness, interfering with gait recovery. OBJECTIVE: To evaluate whether the outcomes after BT-A injection for plantarflexion spasticity can be different according to stroke chronicity. DESIGN: A secondary analysis study from a double-blinded, randomized trial with group reclassification according to stroke chronicity...
March 3, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29304876/a-systematic-review-efficacy-of-botulinum-toxin-in-walking-and-quality-of-life-in-post-stroke-lower-limb-spasticity
#12
Anupam Datta Gupta, Wing Hong Chu, Stuart Howell, Subhojit Chakraborty, Simon Koblar, Renuka Visvanathan, Ian Cameron, David Wilson
BACKGROUND: Improved walking is one of the highest priorities in people living with stroke. Post-stroke lower limb spasticity (PSLLS) impedes walking and quality of life (QOL). The understanding of the evidence of improved walking and QOL following botulinum toxin (BoNTA) injection is not clear. We performed a systematic review of the randomized control trials (RCT) to evaluate the effectiveness of BoNTA injection on walking and QOL in PSLLS. METHODS: We searched PubMed, Web of Science, Embase, CINAHL, ProQuest Thesis and Dissertation checks, Google Scholar, WHO International Clinical Trial Registry Platform, ClinicalTrials...
January 5, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29185676/effect-of-physiotherapeutic-intervention-on-the-gait-after-the-application-of-botulinum-toxin-in-children-with-cerebral-palsy-systematic-review
#13
Paulo R Fonseca, Renata C Franco de Moura, Manuela Galli, Claudia Santos Oliveira
BACKGROUND: Cerebral palsy is a group of movement and posture development disorders. 90% of this population has gait impairment, often due to the presence of spasticity. A number of studies emphasize the importance of combined physical therapy with botulinum toxin A treatment. However, no consensus can be reached concerning the content of the physiotherapy programme after treatment with botulinum toxin A. AIM: The purpose of the present study was to investigate, through a systematic review of the literature, the effects of physiotherapeutic intervention on gait after botulinum toxin application in children with cerebral palsy...
November 29, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29179176/neurons-erythrocytes-and-beyond-the-diverse-functions-of-chorein
#14
Florian Lang, Lisann Pelzl, Ludger Schöls, Andreas Hermann, Michael Föller, Tilman E Schäffer, Christos Stournaras
Chorea-acanthocytosis (ChAc), a neurodegenerative disease, results from loss-of-function-mutations of the chorein-encoding gene VPS13A. Affected patients suffer from a progressive movement disorder including chorea, parkinsonism, dystonia, tongue protrusion, dysarthria, dysphagia, tongue and lip biting, gait impairment, progressive distal muscle wasting, weakness, epileptic seizures, cognitive impairment, and behavioral changes. Those pathologies may be paralleled by erythrocyte acanthocytosis. Chorein supports activation of phosphoinositide-3-kinase (PI3K)-p85-subunit with subsequent up-regulation of ras-related C3 botulinum toxin substrate 1 (Rac1) activity, p21 protein-activated kinase 1 (PAK1) phosphorylation, and activation of several tyrosine kinases...
2017: Neuro-Signals
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
#15
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
#16
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
#17
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
#18
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 with the modest gait defect that is created. Preliminary studies of bone marrow following muscle paralysis suggested acute upregulation of inflammatory cytokines, including TNF-α and IL-1. We therefore hypothesized that BTxA-induced muscle paralysis would rapidly alter the inflammatory microenvironment and the osteoclastic potential of bone marrow...
November 1, 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
#19
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
#20
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)
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