KINEMATIC CHANGES FOLLOWING BOTULINUM TOXIN INJECTION AFTER TRAUMATICBRAIN INJURY

The objectives of this study were to: (1) demonstrate the use of compu terized, three-dimensional gait analysis as a functional assessment in strument following clinical intervention; and (2) objectively quantify the effects of focal muscle denervation via botulinum toxin type A (B TXA) injection in a hemiparetic patient with lower extremity spasticit y following traumatic brain injury (TBI). A desired outcome of this in tervention was to realize kinematics more closely resembling those rep orted for normal patients. The design was a single-subject case study. Ten trials of walking gait were analysed pre-injection (PI), 1 week p ost-injection (1PO) and 4 weeks post-injection(4PO). The PI and 1PO se ssions were found to be appreciably different from the 1PO on the join t angles of the ankle and knee at each phase of the gait cycle. These differences resulted in a reduced asymmetry of ambulation. Stride time , stance time, percentage stance time, percentage swing rime and walki ng speed improved, showing progress towards a more efficient gait patt ern. Decreased stride time and increased walking speed supported impro ved functional ability. The inter-trial variability of the gait parame ters showed the analysis to be a consistently reproducible protocol. C onclusions based on the results included encouraging findings for the efficacy of botulinum toxin A as a therapy for the reduction of spasti city.