F. Reiter et al., LOW-DOSE BOTULINUM TOXIN WITH ANKLE TAPING FOR THE TREATMENT OF SPASTIC EQUINOVARUS FOOT AFTER STROKE, Archives of physical medicine and rehabilitation, 79(5), 1998, pp. 532-535
Objective: To evaluate the efficacy of a combined treatment for spasti
c foot using selective injections of botulinum toxin (BTA) into the ti
bialis posterior muscle followed by ankle taping, and to compare it wi
th current BTA treatment procedure. Design: Single-blind randomized co
ntrol trial. Three-month follow-up after treatment. Setting: Neuroreha
bilitation clinic. Subjects: Eighteen outpatients with equinovarus foo
t due to severe spasticity after stroke. Interventions: (1) Injection
of 190 to 320 BTA U into several calf muscles (group A); (2) injection
of 100 BTA U into the tibialis posterior muscle, followed by ankle-fo
ot taping (group B). Main Outcome Measures: Ankle range of motion (ROM
), Ashworth scale, gait velocity, and step length. Results: Average As
hworth scores decreased 1 point in both groups, but the benefit appear
ed of shorter duration in group B. Changes in both foot position at re
st and passive ankle ROM were observed in all patients, without treatm
ent-related differences, except for gain in passive dorsiflexion that
appeared higher in group A. Gait velocity and step length showed simil
ar increases in both groups. Conclusion: The combination of selective
injections of low BTA doses with ankle-foot taping is as effective as
the injection of the current desks for the reduction of foot inversion
with positive effects on gait parameters. (C) 1998 by the American Co
ngress of Rehabilitation Medicine and the American Academy of Physical
Medicine and Rehabilitation.