Hirsch Mark A, Westhoff Bettina, Toole Tonya, Haupenthal Stephan, Krauspe Rüdiger, Hefter Harald
Charlotte Institute of Rehabilitation, Department of Physical Medicine and Rehabilitation, Charlotte, North Carolina 28203, USA.
Mov Disord. 2005 Aug;20(8):1014-20. doi: 10.1002/mds.20499.
Botulinum toxin (BTX) is often used to improve arm function in persons with hemiparesis after stroke. Persons injected into the arm sometimes report changes in their gait. The purpose of this open-labeled pilot study was to investigate the association between injecting BTX into the upper limb and ankle and knee range of motion (ROM) and paretic-leg stride-time, defined as the time in seconds required to move the hemiparetic leg from initial contact of the foot to initial contact of the same foot. Gait parameters were recorded before and 4 to 6 weeks after the hemiparetic arm was injected with BTX in 13 adults with hemiparesis secondary to stroke, using a three-dimensional computerized motion analysis system. BTX injection into the paretic arm was associated with a decrease in stride-time of the paretic leg in all participants. Slower striding participants improved knee and ankle ROM in the paretic leg. There was no change in ankle and knee ROM in faster striding participants. Injection of BTX into the upper extremity is associated with a change in hemiparetic leg stride-time and ankle and knee ROM. There is a variability of response, with slow striders improving to a greater extent than fast striders.
肉毒杆菌毒素（BTX）常用于改善中风后偏瘫患者的手臂功能。注射到手臂的患者有时会报告其步态发生变化。这项开放性试点研究的目的是调查在上肢和脚踝注射BTX与膝关节和踝关节活动范围（ROM）以及患侧腿步幅时间之间的关联，患侧腿步幅时间定义为患侧偏瘫腿从脚的初始接触到同一只脚再次初始接触所需的秒数。在13名中风后偏瘫的成年人中，使用三维计算机化运动分析系统，在患侧手臂注射BTX之前以及注射后4至6周记录步态参数。对所有参与者而言，向患侧手臂注射BTX与患侧腿步幅时间缩短有关。步幅较慢的参与者患侧腿的膝关节和踝关节活动范围得到改善。步幅较快的参与者踝关节和膝关节活动范围没有变化。向上肢注射BTX与偏瘫腿步幅时间以及踝关节和膝关节活动范围的变化有关。存在反应变异性，步幅慢的参与者比步幅快的参与者改善程度更大。
