Treatment of the spastic drop foot with botulinum toxin type A in adult patients

Spastic drop foot can be managed by physical measures, local pharmacologica l agents, oral anti-spastic drugs and surgical procedures. Recent studies h ave documented the clear effect of botulinum toxin type A (BTX-A) in the tr eatment of the spastic drop foot, particularly by reducing the resistance a gainst passive movement and increasing the range of motion. Functional bene fit and pain reduction have also been observed. The use of BTX-A is safe an d free of serious side effects. Individual realistic treatment goals must b e defined by the rehabilitation team before the treatment. Possible purpose s of the treatment are the achievement of a straight foot to allow weight b earing or application of an orthosis and to reduce the premature activation of the calf muscles during gait. Other treatment goals are the facilitatio n of nursing care, as well as physical and occupational therapy. BTX-A inje ctions can reduce pain, and prevent pressure ulcers or surgical interventio ns. Early physiotherapy or occupational therapy may increase the treatment effect of BTX-A. Close cooperation between the neurologist, physiotherapist , occupational therapist, nursing staff and other multidisciplinary rehabil itation team members is essential to maximize the benefit for the patients.