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Toxins 2018, 10(9), 349; https://doi.org/10.3390/toxins10090349

The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients

1
Department of Rehabilitaion Medicine, The Jikei University School of Medicine, 1058461 Tokyo, Japan
2
Department of Rehabilitaion Medicine, Kikyogahara Hospital 1295, 3996461 Nagano, Japan
*
Author to whom correspondence should be addressed.
Received: 15 August 2018 / Revised: 28 August 2018 / Accepted: 30 August 2018 / Published: 31 August 2018
(This article belongs to the Special Issue Botulinum Toxin Treatment of Movement Disorders)
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Abstract

Objectives: This study is a retrospective investigation of the effects of repetitive botulinum toxin A therapy (BoNT-A) and intensive rehabilitation (IR) on lower limb spasticity in post-stroke patients. Methods: Thirty-five post-stroke patients was included in this study and received BoNT-A for the first time. A 12-day inpatient protocol was with 4 cycles of the treatment protocol. The severity of spasticity, motor function and brace status were evaluated. Results: The modified Ashworth Scale (MAS) score of ankle dorsiflexors, range of motion, walking speed and balancing ability were significantly improved after cycle 1. The improvement of spasticity and motor function was persistent through cycles 2–4. One-third of brace users were able to discontinue the use of a brace. All of these brace users showed a forward gait pattern prior to therapy. Conclusions: Repeated BoNT-A combined with IR improved lower limb spasticity in post-stroke patients. Our results suggest that patients who show the forward gait pattern prior to therapy may be able to discontinue the use of their brace after therapy. View Full-Text
Keywords: botulinum toxin A therapy; stroke; rehabilitation botulinum toxin A therapy; stroke; rehabilitation
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Hara, T.; Abo, M.; Hara, H.; Sasaki, N.; Yamada, N.; Niimi, M.; Shimamoto, Y. The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins 2018, 10, 349.

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