Hesse S, Lücke D, Malezic M, Bertelt C, Friedrich H, Gregoric M, Mauritz K H
Klinik Berlin, Department of Neurological Rehabilitation, Free University of Berlin, Germany.
J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1321-4. doi: 10.1136/jnnp.57.11.1321.
Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including the measurement of vertical ground reaction forces showed a statistically significant (p < 0.01) improvement in velocity, stride length, stance symmetry, and the length of the force point of action under the affected foot. Qualitative improvements on the force diagrams indicated a better loading, advancement of the body, and push off of the affected limb in seven patients. Eight weeks after the injection the effects waned.
12名患有明显下肢伸肌痉挛的慢性偏瘫门诊患者在肌电图引导下，于比目鱼肌、胫后肌和腓肠肌两头注射了400单位A型肉毒杆菌毒素。根据Ashworth量表评估，注射两周后，10名患者的A型肉毒杆菌毒素使跖屈痉挛明显减轻。4名患者受影响的踝关节能够主动背屈。包括垂直地面反作用力测量在内的步态分析显示，速度、步长、站立对称性以及患侧脚下作用力点的长度均有统计学意义的显著改善（p < 0.01）。力图的定性改善表明，7名患者的负重、身体前进和患侧肢体蹬离情况有所改善。注射八周后，效果逐渐减弱。
