[article]
| Titre : |
Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study |
| Type de document : |
texte imprimé |
| Auteurs : |
Alessio Baricich ; Alessandro Picelli ; Stefano Carda ; Nicola Smania ; Carlo Cisari ; Andrea Santamato ; Allessandro de Sire ; Marco Invernizzi |
| Année de publication : |
2019 |
| Article en page(s) : |
p. 214-219 |
| Note générale : |
https://doi.org/10.1016/j.rehab.2019.06.002 |
| Langues : |
Anglais (eng) |
| Mots-clés : |
Stroke Spasticity Botulinum toxin type A Electrical stimulation Rehabilitation |
| Résumé : |
Background
Botulinum toxin type A (BoNT-A) injection is an effective treatment for lower-limb spasticity and should be offered as first-line treatment for focal manifestations. Although its possible role has been hypothesized, the efficacy of electrical stimulation (ES) of antagonists of the injected muscles for improving clinical outcome after BoNT-A injection remains to be established.
Objectives
This randomized single-blind pilot study aimed to investigate the efficacy of ES of antagonist muscles as adjunct treatment after BoNT-A injection to plantar flexor muscles in hemiplegic patients with spastic equinus foot.
Methods
After BoNT-A injection at triceps surae, patients were randomly allocated to 2 groups: group 1, single ES session on injected muscles plus 5 sessions of ES on antagonist muscles, and group 2, single ES session on injected muscles alone. Both groups underwent daily physical therapy for 60 min for 2 weeks (5 days/week). Assessments were performed before treatment (T0) and at 10 days (T1), 20 days (T2), and 90 days (T3) after treatment. Our primary outcome was gait velocity at a comfortable speed at T2 (10-m walk test [10MWT]). The following were secondary outcomes: triceps surae spasticity (Modified Ashworth Scale), ankle passive range of motion (pROM), strength of tibialis anterior muscle, and 2-min walk test (2MWT).
Results
The 30 patients enrolled were randomly allocated to the 2 groups: 15 in group 1 and 15 in group 2. At T1, T2 and T3, both groups showed a significant reduction in muscle tone and an increase in ankle pROM (P < 0.05). At T2 and T3, both groups showed a significant increase in 10MWT and 2MWT. The groups did not significantly differ in tibialis anterior strength or primary or secondary outcome measures.
Conclusions
ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection. |
| En ligne : |
https://www.sciencedirect.com/science/article/pii/S1877065719300752 |
| Permalink : |
./index.php?lvl=notice_display&id=84125 |
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 214-219
[article] Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study [texte imprimé] / Alessio Baricich ; Alessandro Picelli ; Stefano Carda ; Nicola Smania ; Carlo Cisari ; Andrea Santamato ; Allessandro de Sire ; Marco Invernizzi . - 2019 . - p. 214-219. https://doi.org/10.1016/j.rehab.2019.06.002 Langues : Anglais ( eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 214-219
| Mots-clés : |
Stroke Spasticity Botulinum toxin type A Electrical stimulation Rehabilitation |
| Résumé : |
Background
Botulinum toxin type A (BoNT-A) injection is an effective treatment for lower-limb spasticity and should be offered as first-line treatment for focal manifestations. Although its possible role has been hypothesized, the efficacy of electrical stimulation (ES) of antagonists of the injected muscles for improving clinical outcome after BoNT-A injection remains to be established.
Objectives
This randomized single-blind pilot study aimed to investigate the efficacy of ES of antagonist muscles as adjunct treatment after BoNT-A injection to plantar flexor muscles in hemiplegic patients with spastic equinus foot.
Methods
After BoNT-A injection at triceps surae, patients were randomly allocated to 2 groups: group 1, single ES session on injected muscles plus 5 sessions of ES on antagonist muscles, and group 2, single ES session on injected muscles alone. Both groups underwent daily physical therapy for 60 min for 2 weeks (5 days/week). Assessments were performed before treatment (T0) and at 10 days (T1), 20 days (T2), and 90 days (T3) after treatment. Our primary outcome was gait velocity at a comfortable speed at T2 (10-m walk test [10MWT]). The following were secondary outcomes: triceps surae spasticity (Modified Ashworth Scale), ankle passive range of motion (pROM), strength of tibialis anterior muscle, and 2-min walk test (2MWT).
Results
The 30 patients enrolled were randomly allocated to the 2 groups: 15 in group 1 and 15 in group 2. At T1, T2 and T3, both groups showed a significant reduction in muscle tone and an increase in ankle pROM (P < 0.05). At T2 and T3, both groups showed a significant increase in 10MWT and 2MWT. The groups did not significantly differ in tibialis anterior strength or primary or secondary outcome measures.
Conclusions
ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection. |
| En ligne : |
https://www.sciencedirect.com/science/article/pii/S1877065719300752 |
| Permalink : |
./index.php?lvl=notice_display&id=84125 |
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