Does botulinum toxin injection site determine outcome in post-stroke plantarflexion spasticity? Comparison study of two injection sites in the gastrocnemius muscle: a randomized double-blind controlled trial

摘要: Objective:To determine if botulinum toxin type A injection at the proximal 2/10 and 3/10 of calf length, where intramuscular nerve endings gastrocnemius muscle are densely distributed, is more efficacious in controlling plantarflexion spasticity than distant sites within same muscle.Design:A double-blind randomized controlled trial.Settting:Two rehabilitation centres.Subjects:Forty stroke patients were randomly allocated to two groups. Group received group B below midbelly muscle. Both groups 200 IU followed up eight weeks.Main measures:Primary variables surface electromyography values recorded during plantarflexion; secondary Modified Ashworth Scale, Tardieu clonus scale, 10-metre walking test, ABILOCO Functional Ambulation Categories.Results:At baseline, median Scale was 2.0 (range,1+ −3.0),...