SHORT-TERM ELECTRICAL-STIMULATION ENHANCES THE EFFECTIVENESS OF BOTULINUM TOXIN IN THE TREATMENT OF LOWER-LIMB SPASTICITY IN HEMIPARETIC PATIENTS

The study tested the spasmolytic effect of Botulinum toxin A in two gr oups of hemiparetic patients with lower limb spasticity: in the first group (n = 5) 2000 U Dysport were injected into the soleus, tibialis p osterior and both heads of gastrocnemius muscles alone; the second (n = 5) received additional repetitive alternating electrical stimulation of M. tibialis anterior and plantar flexors for 30 min six times per day during the 3 days following the injection. Muscle tone, rated by t he Ashworth spasticity score, and gait analysis including recording of vertical ground reaction forces, were assessed before and 4 weeks aft er injection. The combined treatment proved to be more effective with respect to the clinically assessed reduction of muscle tone, gait velo city, stride length, stance- and swing-symmetry (P < 0.05). The result is discussed with reference to animal experiments demonstrating enhan ced toxin uptake and accelerated onset of its paralytic effect by elec trical stimulation.