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Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study / Alessio Baricich in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
[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 Exemplaires (1)
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Exclu du prêtClinical and MRI changes of puborectalis and iliococcygeus after a short period of intensive pelvic floor muscles training with or without instrumentation / Frédéric Dierick
Titre : Clinical and MRI changes of puborectalis and iliococcygeus after a short period of intensive pelvic floor muscles training with or without instrumentation Type de document : document électronique Auteurs : Frédéric Dierick ; Ekatrina Galtsova ; Clara Lauer ; Fabien Buisseret ; Anne-France Bouché ; Laurent Martin Année de publication : 2018 Note générale : Cet article est une pré-publication. La version définitive a été publiée dans la revue "European Journal of Applied Physiology" 118, (2018)sous le doi: 10.1007/s00421-018-3899-7. Langues : Anglais (eng) Mots-clés : Anatomy Levator ani Transversus abdominis Strengthening Morphology Hypopressive Biofeedback Electrical stimulation Résumé : Purpose
This study evaluates the impact of a 3-week period of intensive pelvic floor muscles training (PFMT), with or without instrumentation, on clinical and static magnetic resonance imaging (MRI) changes of puborectalis (PR) and iliococcygeus (IL) muscles.
Methods
24 healthy young women were enrolled in the study and 17 achieved the 9 sessions of 30 min training exercises and conducted all assessments. Participants were randomly assigned in two training groups: voluntary contractions combined with hypopressive exercises (HYPO) or biofeedback exercises combined with transvaginal electrical stimulations (ELEC). Clinical and T2-weighted MRI assessments were realized before and after training.
Results
Modified Oxford Grading System (MOGS) scores for left PR and perineal body significantly increased in the two groups (p = 0.039, p = 0.008), but MOGS score for right PR significantly increased only in HYPO (p = 0.020). Muscle volumes of right and left IL significantly decreased (p = 0.040, p = 0.045) after training as well as signal intensities of right and left PR (p = 0.040, p = 0.021) and thickness of right and left IL at mid-vagina location (p = 0.012, p = 0.011).
Conclusions
A short period of intensive PFMT induces clinical and morphological changes in PFMs at rest suggesting a decrease in IL volume and adipose content of PR. Although the results suggested that an intensive non-instrumented PFMT is as effective as an instrumented training, future controlled studies with greater sample sizes are needed to establish the relative and absolute effectiveness of each of the two interventions.En ligne : https://www.biorxiv.org/content/10.1101/248823v1.full Permalink : ./index.php?lvl=notice_display&id=84499 Clinical and MRI changes of puborectalis and iliococcygeus after a short period of intensive pelvic floor muscles training with or without instrumentation [document électronique] / Frédéric Dierick ; Ekatrina Galtsova ; Clara Lauer ; Fabien Buisseret ; Anne-France Bouché ; Laurent Martin . - 2018.
Cet article est une pré-publication. La version définitive a été publiée dans la revue "European Journal of Applied Physiology" 118, (2018)sous le doi: 10.1007/s00421-018-3899-7.
Langues : Anglais (eng)
Mots-clés : Anatomy Levator ani Transversus abdominis Strengthening Morphology Hypopressive Biofeedback Electrical stimulation Résumé : Purpose
This study evaluates the impact of a 3-week period of intensive pelvic floor muscles training (PFMT), with or without instrumentation, on clinical and static magnetic resonance imaging (MRI) changes of puborectalis (PR) and iliococcygeus (IL) muscles.
Methods
24 healthy young women were enrolled in the study and 17 achieved the 9 sessions of 30 min training exercises and conducted all assessments. Participants were randomly assigned in two training groups: voluntary contractions combined with hypopressive exercises (HYPO) or biofeedback exercises combined with transvaginal electrical stimulations (ELEC). Clinical and T2-weighted MRI assessments were realized before and after training.
Results
Modified Oxford Grading System (MOGS) scores for left PR and perineal body significantly increased in the two groups (p = 0.039, p = 0.008), but MOGS score for right PR significantly increased only in HYPO (p = 0.020). Muscle volumes of right and left IL significantly decreased (p = 0.040, p = 0.045) after training as well as signal intensities of right and left PR (p = 0.040, p = 0.021) and thickness of right and left IL at mid-vagina location (p = 0.012, p = 0.011).
Conclusions
A short period of intensive PFMT induces clinical and morphological changes in PFMs at rest suggesting a decrease in IL volume and adipose content of PR. Although the results suggested that an intensive non-instrumented PFMT is as effective as an instrumented training, future controlled studies with greater sample sizes are needed to establish the relative and absolute effectiveness of each of the two interventions.En ligne : https://www.biorxiv.org/content/10.1101/248823v1.full Permalink : ./index.php?lvl=notice_display&id=84499 Exemplaires
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