A Randomized Controlled Trial of Selective Neurotomy Versus Botulinum Toxin for Spastic Equinovarus Foot After Stroke.

摘要: BACKGROUND: . Selective neurotomy is a permanent treatment of focal spasticity, and its effectiveness in treating spastic equinovarus the foot (SEF) was previously suggested by few nonrandomized uncontrolled case-series studies. OBJECTIVES: This study first assessor-blinded, randomized, controlled trial evaluating effects this treatment. METHODS: Sixteen chronic stroke patients presenting with SEF were randomized into 2 groups: 8 underwent tibial remaining received botulinum toxin (BTX) injections. The soleus treated all patients, tibialis posterior flexor hallucis longus about half patients. primary outcome quantitative measurement ankle stiffness (L-path), an objective directly related to spasticity. Participants assessed blind assessor before their intervention at 6 months after Evaluations based on 3 domains International Classification Functioning, Disability Health (ICF). RESULTS: Compared BTX, induced higher reduction stiffness. Both treatments comparable improvement kinematics during gait, whereas neither muscle weakening. Activity, participation, quality life not significantly modified either group. CONCLUSIONS: demonstrates that nerve effective SEF, reducing impairments observed Future studies should be conducted confirm long-term efficacy ICF domains.