Onabotulinumtoxin-A injection for disabling lower limb flexion in hemiplegic patients.

摘要: BACKGROUND: Hemiplegic patients with supraspinal spasticity can present a flexor pattern at the hip and knee that hampers both passive active functions. OBJECTIVE: To investigate efficacy of OnabotulinumtoxinA injections on this scheme. METHODS: This open-label observational study included eleven who had suffered unilateral stroke or traumatic brain injury. All impairment in activities daily living caused by severe flexion. 300–400U (total dose) were administered to iliopsoas (iliacus) flexors and, when necessary, other muscles knee. Evaluations performed pre-treatment (weeks − 4t o−8, day 1) post-treatment (week 10 week 21): spasticity, range motion, limb positioning, functions pain. RESULTS: A modest improvement extension was observed, as evidenced Modified Ashworth Score movements. Limb positioning also improved. Clear benefits found functioning, including toileting, dressing bed facilities, well pain levels. Active remained unchanged. More definite difficulties. CONCLUSIONS: injection contribute reducing consequences disabling lower