Farina Simona, Migliorini Claudia, Gandolfi Marialuisa, Bertolasi L, Casarotto Matteo, Manganotti Paolo, Fiaschi Antonio, Smania Nicola
Department of Neurology and Vision Science, University of Verona, Italy.
Funct Neurol. 2008 Apr-Jun;23(2):87-91.
Optimal treatment of spasticity requires a combination of pharmacotherapy and muscle lengthening. We evaluated 13 stroke patients with equinovarus foot randomized to treatment with either botulinum toxin A (BTA) injection plus ankle-foot casting (n=6) or BTA alone (n=7). The tibialis posterior and calf muscles (range of BTA injection: 190 to 320 U) were treated in each patient. Castings were worn at night for four months. Each patient was examined before, and at two and four months after BTA injection using the static and dynamic baropodometric tests, the Modified Ashworth Scale and the 10-meter walking test. At two months, therapeutic effects were observed in both groups. At four months, the study group showed further clinical improvement, while the control group returned to baseline performance. Thus, prolonged stretching of spastic muscles after BTA injection affords long-lasting therapeutic benefit, enhancing the effects of the toxin alone.
痉挛的最佳治疗需要药物治疗和肌肉延长术相结合。我们评估了13例足内翻的中风患者，将其随机分为两组，一组接受肉毒杆菌毒素A（BTA）注射加踝足支具治疗（n = 6），另一组仅接受BTA治疗（n = 7）。每位患者均接受胫后肌和小腿肌肉治疗（BTA注射剂量范围：190至320单位）。支具在夜间佩戴四个月。每位患者在BTA注射前、注射后两个月和四个月时，使用静态和动态足底压力测试、改良Ashworth量表和10米步行测试进行检查。两个月时，两组均观察到治疗效果。四个月时，研究组临床症状进一步改善，而对照组恢复到基线水平。因此，BTA注射后对痉挛肌肉进行长时间拉伸可带来持久的治疗益处，增强单独使用毒素的效果。
