重复肉毒毒素 A 治疗联合强化康复对脑卒中后患者下肢痉挛的影响。
The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients.
机构信息
Department of Rehabilitaion Medicine, The Jikei University School of Medicine, 1058461 Tokyo, Japan.
Department of Rehabilitaion Medicine, Kikyogahara Hospital 1295, 3996461 Nagano, Japan.
出版信息
Toxins (Basel). 2018 Aug 31;10(9):349. doi: 10.3390/toxins10090349.
OBJECTIVES
This study is a retrospective investigation of the effects of repetitive botulinum toxin A therapy (BoNT-A) and intensive rehabilitation (IR) on lower limb spasticity in post-stroke patients.
METHODS
Thirty-five post-stroke patients was included in this study and received BoNT-A for the first time. A 12-day inpatient protocol was with 4 cycles of the treatment protocol. The severity of spasticity, motor function and brace status were evaluated.
RESULTS
The modified Ashworth Scale (MAS) score of ankle dorsiflexors, range of motion, walking speed and balancing ability were significantly improved after cycle 1. The improvement of spasticity and motor function was persistent through cycles 2⁻4. One-third of brace users were able to discontinue the use of a brace. All of these brace users showed a forward gait pattern prior to therapy.
CONCLUSIONS
Repeated BoNT-A combined with IR improved lower limb spasticity in post-stroke patients. Our results suggest that patients who show the forward gait pattern prior to therapy may be able to discontinue the use of their brace after therapy.
目的
本研究为回顾性调查，旨在研究重复肉毒毒素 A 治疗（BoNT-A）和强化康复（IR）对脑卒中后患者下肢痉挛的影响。
方法
本研究纳入 35 例脑卒中后首次接受 BoNT-A 治疗的患者。采用为期 12 天的住院方案，包括 4 个周期的治疗方案。评估痉挛严重程度、运动功能和支具状态。
结果
第 1 周期后，踝背屈肌的改良 Ashworth 量表（MAS）评分、运动范围、步行速度和平衡能力均显著改善。通过第 2⁻4 个周期，痉挛和运动功能的改善得以持续。三分之一的支具使用者能够停止使用支具。所有这些支具使用者在治疗前均表现出前向步态模式。
结论
重复 BoNT-A 联合 IR 可改善脑卒中后患者的下肢痉挛。我们的研究结果表明，治疗前表现出前向步态模式的患者在治疗后可能能够停止使用支具。
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