Affiliations: [a] U.O.P. Professioni della Riabilitazione, Azienda Ospedaliera Universitaria Senese, Siena, Italy | [b] Scuola di Dottorato in Scienze Cognitive, Universitá degli Studi di Siena, Siena, Italy | [c] S.C. Neurologia e Neurofisiologia Clinica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
Correspondence:
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Address for correspondence: Dr. Riccardo Mazzocchio, S.C. Neurologia e Neurofisiologia Clinica, Azienda Ospedaliera Universitaria Senese, Siena, Italy. Tel.: +39 577 233409; Fax: +39 0577 40327; E-mail: mazzocchio@unisi.it
Abstract: Background:Botulinum neurotoxin A (BoNT-A) may reduce lower limb spasticity but its role in improving walking ability remains to be established. Objective:To investigate the efficacy of simultaneous BoNT-A injections into several targeted spastic muscles of different joints on gait speed and on functional gains in gait performance in chronic stroke and MS patients. Methods:Twenty patients affected by stroke or multiple sclerosis were tested before, one and three months after BoNT-A administration. Gait was evaluated by the 10 Meter Walk Test; patients were stratified into functional ambulation classes accordingly. Spasticity was assessed using the modified Ashworth Scale. Results:At final assessment, spasticity was reduced in hip adductors and ankle plantar-flexors, gait speed improved and, 1/3rd of patients transitioned to a higher ambulation class. The pre-post difference in Level of Spasticity of the hips was a predictor for an increase in gait speed. Conclusions:A meaningful improvement in walking performance can be obtained in chronic spastic patients after BoNT-A injection into several muscles, specifically the hip adductors.
Keywords: Botulinum Neurotoxin A, BoNT-A, spasticity, gait
