Fujita Kazuki, Kobayashi Yasutaka, Hitosugi Masahito, Nomura Tomomi, Nishida Tomoko, Tsushima Yuichi, Ogawa Tomoki, Kinoshita Hirotaka, Hori Hideaki
Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, Fukui, Japan.
Department of Legal Medicine, Shiga University of Medical Science, Otsu, Japan.
Prog Rehabil Med. 2020 Oct 7;5:20200024. doi: 10.2490/prm.20200024. eCollection 2020.
In patients with hemiplegia, botulinum toxin type A injection for ankle spasticity of the plantar flexors reportedly improves walking speed. This improvement may be affected by background factors and patient baseline physical performance. This study aimed to clarify the factors affecting gait velocity improvement after botulinum toxin type A injection.
Background and evaluation data were collected for 60 patients with stroke who received botulinum toxin type A injection for spasticity of the plantar flexors. The patients were divided into improvement (n=27) and non-improvement (n=33) groups based on the gait velocity change from before injection to 2 weeks after injection. Logistic regression analysis was performed with the improvement and non-improvement groups as response variables and background data and evaluation data at baseline as explanatory variables.
The presence or absence of physical therapy following botulinum toxin type A injection (odds ratio: 7.82) was the only significant explanatory variable for gait velocity change.
Background factors and physical performance at baseline did not affect gait velocity improvement after botulinum toxin type A injection. If botulinum treatment of the ankle plantar flexors in patients with stroke is targeted at walking performance improvement, then physical therapy following botulinum toxin type A injection should be an essential part of the treatment strategy.
据报道，对于偏瘫患者，注射A型肉毒杆菌毒素治疗踝跖屈肌痉挛可提高步行速度。这种改善可能会受到背景因素和患者基线身体表现的影响。本研究旨在阐明影响A型肉毒杆菌毒素注射后步态速度改善的因素。
收集了60例因踝跖屈肌痉挛接受A型肉毒杆菌毒素注射的中风患者的背景和评估数据。根据注射前至注射后2周的步态速度变化，将患者分为改善组（n = 27）和未改善组（n = 33）。以改善组和未改善组作为反应变量，以基线时的背景数据和评估数据作为解释变量进行逻辑回归分析。
注射A型肉毒杆菌毒素后是否进行物理治疗（优势比：7.82）是步态速度变化的唯一显著解释变量。
背景因素和基线时的身体表现不会影响A型肉毒杆菌毒素注射后步态速度的改善。如果对中风患者的踝跖屈肌进行肉毒杆菌治疗旨在改善步行表现，那么注射A型肉毒杆菌毒素后的物理治疗应成为治疗策略的重要组成部分。
