Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, 148 Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, 73, Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea.
Sci Rep. 2023 May 24;13(1):8426. doi: 10.1038/s41598-023-35562-1.
The purpose of this study was to clarify the association between improvement of spasticity in hemiplegic patient's upper extremity with Botulinum toxin injection and improvement in postural balance and gait function. For this prospective cohort study, sixteen hemiplegic stroke patients with upper extremity spasticity were recruited. The plantar pressure with gait parameters, postural balance parameters, Modified Ashworth Scale, and Modified Tardieu Scale were evaluated before, 3 weeks and 3 months after Botulinum toxin A (BTxA) injection. Spasticity of hemiplegic upper extremity before, and after BTxA injection were significantly changed. Plantar pressure overload in affected side was reduced after BTxA injection. The mean X-speed and the horizontal distance decreased in postural balance analysis with eyes-opened test. Improvement in hemiplegic upper extremity spasticity showed positive correlation with gait parameters. In addition, improvement in hemiplegic upper extremity spasticity was positively correlated with change in balance parameters in postural balance analysis with eyes-closed and dynamic tests. This study focused on the effect of stroke patient's hemiplegic upper extremity spasticity on their gait and balance parameters and identified that the BTxA injection on hemiplegic patient's spastic upper extremity improve postural balance and gait function.
本研究旨在阐明偏瘫患者上肢痉挛性改善与姿势平衡和步态功能改善之间的关系。本前瞻性队列研究共纳入 16 例上肢痉挛性偏瘫脑卒中患者。在肉毒毒素 A(BTxA)注射前、3 周和 3 个月,评估了足底压力和步态参数、姿势平衡参数、改良 Ashworth 量表和改良 Tardieu 量表。偏瘫上肢痉挛性在 BTxA 注射前后均有显著变化。BTxA 注射后,患侧足底压力过载减少。在睁眼姿势平衡分析中,平均 X 速度和水平距离减小。偏瘫上肢痉挛性的改善与步态参数呈正相关。此外,偏瘫上肢痉挛性的改善与闭眼和动态试验中姿势平衡分析中平衡参数的变化呈正相关。本研究关注脑卒中患者偏瘫上肢痉挛性对其步态和平衡参数的影响,发现 BTxA 注射可改善偏瘫患者痉挛性上肢的姿势平衡和步态功能。