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Botulinum toxin gait

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
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
Philippe Gallien, Benoit Nicolas, Leblong Emilie, Sabine Petrilli, Sandrine Robineau, Aurelie Durufle, Katell Autret, Tiphaine Berthier, Lucie Chochina, Bastien Fraudet, Corinne Pfeiffer
INTRODUCTION: Few data are available on the use of botulinum toxin for spasticity treatment in multiple sclerosis. In a previous study, we found that one of the main therapeutic goals was the improvement ok walking, in patients suffering from spasticity of the triceps surae. OBJECTIVE: This is a pilot observational study, with the aim to assess the benefit of an injection of 200 UI of incobotulinumtoxin A in multiple sclerosis patients suffering from spasticity du triceps surae...
September 2016: Annals of Physical and Rehabilitation Medicine
Nigar Dursun, Tugba Gokbel, Melike Akarsu, Erbil Dursun
OBJECTIVE: Physical therapy (PT) and botulinum toxin-A (BTX-A) injections are widely used in the treatment of spastic equinus foot due to cerebral palsy. The aim of this study was to show effects of intermittent serial casting (SC) in addition to standard treatment on spasticity, passive range of motion (PROM), and gait. DESIGN: Fifty-one ambulatory patients, treated by BTX-A to plantar flexor muscles, were randomly assigned to casting or control groups in a 2:1 ratio...
September 14, 2016: American Journal of Physical Medicine & Rehabilitation
Emanuele Spina, Antonio Carotenuto, Maria Gabriella Aceto, Ilaria Cerillo, Francesco Silvestre, Francesco Arace, Paolo Paone, Giuseppe Orefice, Rosa Iodice
BACKGROUND: Multiple Sclerosis is a heterogeneous disorders involving in early stage gait and balance. Together with immunomodulating therapies, rehabilitation had a crucial role in improving motor tasks and quality of life. Between the emerging techniques, Focal Vibrations (FV) could play a role, but they have been used in MS only to reduce muscle tone and fatigue alone or together with botulinum toxin. OBJECTIVE: To assess whether FV is effective on walking impairment in a cohort of MS patients...
September 21, 2016: Restorative Neurology and Neuroscience
Wing Hong Chu, Anupam Datta Gupta
The objective of this review is to examine the current best available evidence on the effectiveness of botulinum toxin type A on gait (velocity and distance) and quality of life (QoL) in adult post-stroke patients with lower limb spasticity.More specifically, this review aims to determine the effectiveness of botulinum toxin type A on adult post-stroke patients with lower limb spasticity in relation to.
June 2016: JBI Database of Systematic Reviews and Implementation Reports
Veronica A Bruno, Susan H Fox, Deborah Mancini, Janis M Miyasaki
BACKGROUND: Parkinson's disease (PD) and other parkinsonian syndromes are chronic, progressive neurodegenerative diseases. With advancing disease, both motor and non-motor symptoms represent a considerable burden and symptom relief and quality of life improvement become the main goal of treatment. Botulinum toxins (BTX) are an effective treatment modality for many neurological conditions. METHODS: To understand the potential usefulness of BTX in this population, we performed a retrospective chart review of all patients with a clinical diagnosis of idiopathic PD and atypical parkinsonism who received treatment with BTX injections in our center from 1995 to 2014 for a variety of symptoms...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Sibel Kibar, Ferdi Yavuz, Birol Balaban
Diagnosis of Adult Idiopathic Toe Walking (AITW) is very rare in clinical practice. High quality studies regarding AITW and its treatment options have not been conducted previously. A 28-year-old male patient complaining of lower leg pain was referred to outpatient rehabilitation clinic. Physical examination revealed a gait abnormality of insufficient heel strike at initial contact. The aetiology was investigated and the patient's walking parameters were assessed using a computerized gait analysis system. The AITW was diagnosed...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Chiharu Yasuda, Takanobu Takei, Takenori Uozumi, Tomoko Toyota, Tomoaki Yuhi, Hiroaki Adachi
Parkinsonism and dystonia are both disorders of the extrapyramidal motor system, and some patients exhibit a complex of the two symptoms. Although several reports have referred to the coexistence of these disorders as parkinsonian disorders with dystonia, in the majority of cases, dystonia appeared after parkinsonism. DAT-scan is useful for the early diagnosis of Parkinson's disease (PD) and other types of parkinsonism such as dementia with Lewy bodies. This case report describes a 67-year old woman diagnosed with axial dystonia without parkinsonism 6 years previously, which had worsened despite treatment with Botulinum toxin injections, and hindered the patient's gait...
September 29, 2016: Rinshō Shinkeigaku, Clinical Neurology
Juan F Vázquez-Costa, Inmaculada Máñez, Ana Alabajos, Maricruz Guevara Salazar, Cristina Roda, Teresa Sevilla
Spasticity can be a very disabling problem in some amyotrophic lateral sclerosis (ALS) phenotypes, such as upper motor neuron-dominant ALS (UMN-D ALS) and primary lateral sclerosis (PLS). Our aim is to describe the safety and efficacy of botulinum toxin A (BoTox-A) for improving gait in those ALS phenotypes. UMN-D ALS and PLS outpatients experiencing gait disturbances, secondary to moderate-to-severe spasticity despite optimized oral medication, were offered BoTox-A treatment. Stretching exercises were indicated to complement BoTox-A effect, and ankle-foot orthotics were prescribed when appropriate...
October 2016: Journal of Neurology
Erin E Butler, Katherine M Steele, Leslie Torburn, James G Gamble, Jessica Rose
BACKGROUND: This case report provides a unique look at the progression of crouch gait in a child with cerebral palsy over an 8-year time period, through annual physical examinations, three-dimensional gait analyses, and evaluation of postural balance. Our patient received regular botulinum toxin-A injections, casting, and physical therapy but no surgical interventions. CASE PRESENTATION: A white American boy with spastic diplegic cerebral palsy was evaluated annually by clinical motion analyses, including physical examination, joint kinematics, electromyography, energy expenditure, and standing postural balance tests, from 6 to 13 years of age...
2016: Journal of Medical Case Reports
Miroslav Vastik, Pavel Hok, Petr Hlustik, Pavel Otruba, Zbyněk Tüdös, Petr Kanovsky
BACKGROUND: Freezing of gait (FOG) is a common disabling symptom of (in) Parkinson's disease (PD). The mechanism of FOG is (in) not clearly understood. We investigated the clinical effect and changes of the activity of the sensorimotor system using repeated functional MRI (fMRI) before and after application of botulinum toxin in Parkinson's disease patients with FOG. METHODS: We investigated 20 patients with PD, 10 with FOG and 10 without FOG. PD patients with FOG were treated with intramuscular application of botulinum toxin type A into the tensor fasciae latae muscle bilaterally...
2016: Neuro Endocrinology Letters
Frédéric Chantraine, Céline Schreiber, Elisabeth Kolanowski, Florent Moissenet
BACKGROUND AND PURPOSE: Abnormal knee hyperextension during the stance phase (genu recurvatum) is a common gait abnormality in persons with hemiparesis due to stroke. While ankle-foot orthoses (AFOs) are often used to prevent genu recurvatum by maintaining ankle dorsiflexion during the stance phase, AFOs reduce ankle joint mobility. Functional electrical stimulation (FES) is an alternative to the use of AFO for producing appropriately timed ankle dorsiflexion and with prolonged timing may also have value for reducing genu recurvatum...
July 2016: Journal of Neurologic Physical Therapy: JNPT
Anupam Datta Gupta, Renuka Visvanathan
BACKGROUND: Six patients with Parkinson's disease with deep brain stimulation who were experiencing disabling foot dystonia were referred to the spasticity clinic for a trial of botulinum toxin. The foot and ankle muscles were injected with onabotulinum toxin (Botox) to determine the effects on foot dystonia, pain and lower limb functional outcomes. DESIGN: Case series. SUBJECTS/PATIENTS: Six patients with Parkinson's disease with deep brain stimulation experiencing disabling foot dystonia...
June 13, 2016: Journal of Rehabilitation Medicine
Alessandro Picelli, Marco Bacciga, Camilla Melotti, Elisabetta LA Marchina, Elisabetta Verzini, Federico Ferrari, Angelo Pontillo, Jessica Corradi, Stefano Tamburin, Leopold Saltuari, Claudio Corradini, Andreas Waldner, Nicola Smania
BACKGROUND: Despite the growing evidence about the use of robotic gait training in neurorehabilitation, there is a scant literature about the combined effects of this innovative technological approach and a first-line treatment for focal spasticity as botulinum toxin type A. In particular, to the best of our knowledge, no previous study evaluated if robotic gait training may enhance the antispastic effect of botulinum toxin type A. AIM: To evaluate the combined effects of robot-assisted gait training and botulinum toxin type A on spastic equinus foot in patients with chronic stroke...
April 21, 2016: European Journal of Physical and Rehabilitation Medicine
Tao Wu, Jian Hua Li, Hai Xin Song, Yan Dong
OBJECTIVES: To evaluate current evidence of the effectiveness of botulinum toxin (BTX) injection for lower limbs spasticity after stroke. METHODS: Ovid MEDLINE(R) In-Process and Other Non-Indexed Citations,Ovid MEDLINE(R), Ovid EMBASE, Web of Science, and PubMed (NLM) from database were searched inception through Week 23, 2015. Randomized controlled trials (RCTs) comparing the clinical efficacy of BTX injection to placebo or conventional therapy on lower limbs spasticity after stroke were included...
June 2016: Topics in Stroke Rehabilitation
Shuchen Ding, Xuewei Fang, Rongbin Yu, Zhengang Liu, Fu Chudi, Yi Lai, Zhang Zhiwu, Yisheng Lu
OBJECTIVE: To provides an objective tool to evaluate rotator cuff function in rats. METHODS: Sixty adult male Sprague Dawley rats, weighing (281.21 ± 20.12) g, were involved in this experiment. Botulinum toxin A (6 U/kg) was injected into the infraspinatus of 12 rats in Botox group. Infraspinatus tendons of 12 rats in tear group were cut by microinvasive method. Infraspinatus tendons of 12 rats in sham-operation group were exposed but not cut. No any treatment was performed on the 12 rats in normal control group...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Kristina Löwing, Karin Thews, Yvonne Haglund-Åkerlind, Elena M Gutierrez-Farewik
AIMS: To evaluate short and long-term effects of botulinum toxin-A combined with goal-directed physiotherapy in children with cerebral palsy (CP). METHOD: A consecutive selection of 40 children, ages 4-12 years, diagnosed with unilateral or bilateral CP, and classified in GMFCS levels I-II. During the 24 months, 9 children received one BoNT-A injection, 10 children two injections, 11 children three injections, and 10 children received four injections. 3D gait analysis, goal-attainment scaling, and body function assessments were performed before and at 3, 12, and 24 months after initial injections...
April 8, 2016: Physical & Occupational Therapy in Pediatrics
Angela Nieuwenhuys, Eirini Papageorgiou, Todd Pataky, Tinne De Laet, Guy Molenaers, Kaat Desloovere
AIM: This study aimed at comparing two statistical approaches to analyze the effect of Botulinum Toxin A (BTX-A) treatment on gait in children with a diagnosis of spastic cerebral palsy (CP), based on three-dimensional gait analysis (3DGA) data. Through a literature review, the available expert knowledge on gait changes after BTX-A treatment in children with CP is summarized. METHODS: Part 1--Intervention studies on BTX-A treatment in children with CP between 4-18 years that used 3DGA data as an outcome measure and were written in English, were identified through a broad systematic literature search...
2016: PloS One
Yu-Ching Lin, I-Ling Lin, Te-Feng Arthur Chou, Hsin-Min Lee
BACKGROUND: Cerebral palsy (CP) is the most common pediatric disease to cause motor disability. Two common symptoms in CP are spasticity and contracture. If this occurred in the ankle plantar flexors of children with CP, it will impair their gait and active daily living profoundly. Most children with CP receive botulinum toxin type A (BoNT-A) injection to reduce muscle tone, but a knowledge gap exists in the understanding of changes of neural and non-neural components of spasticity after injection...
2016: Journal of Neuroengineering and Rehabilitation
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