Are gait and mobility measures responsive to change following botulinum toxin injections in adults with lower limb spasticity?

被引:8
作者
Chan, Joyce [1 ,2 ]
Winter, Adele [3 ]
Palit, Mithu [4 ]
Sturt, Rod [3 ]
de Graaff, Stephen [4 ]
Holland, Anne E. [1 ,5 ]
机构
[1] La Trobe Univ, Sch Physiotherapy, Bundoora, Vic 3068, Australia
[2] Royal Melbourne Hosp, Dept Physiotherapy, Parkville, Vic 3050, Australia
[3] Caulfield Hosp, Dept Physiotherapy, Caulfield, Australia
[4] Caulfield Hosp, Caulfield, Australia
[5] Alfred Hosp, Dept Physiotherapy, Melbourne, Vic 3004, Australia
关键词
Botulinum toxin; gait; neurological disorders; outcome measurement error; spasticity; TERM ELECTRICAL-STIMULATION; DOUBLE-BLIND; MUSCLE-ACTIVITY; CEREBRAL-PALSY; DROP FOOT; MANAGEMENT; CHILDREN; STROKE; VARIABILITY; DISORDERS;
D O I
10.3109/09638288.2012.717579
中图分类号
R49 [康复医学];
学科分类号
100232 [康复医学];
摘要
Purpose: To determine whether gait and mobility measures are responsive to change following botulinum toxin (BoNT) injections in adults with lower limb spasticity. Method: Independently ambulant adults who attended a spasticity clinic for lower limb BoNT injections were eligible to participate. The 10 m walk test (shoes on and off), timed up and go test and 6-min walk test were performed before injection and 1 month later. Participants completed a global rating of change scale (GRCS) at follow up. Comparisons were made between participants' ratings of change and change in walking performance. Effect sizes (ES) and standard error of measurement (SEM) were calculated for each outcome. Results: Thirty-nine patients (22 female, 17 male; mean age 51 +/- 12 years; range 26-74 years) with a median spasticity duration of 53 months participated. Statistically significant changes were found in all gait and mobility measures at 1 month following injection. All ES were small (<0.2) and SEM for each measure was large. The global rating of change scale (GRCS) indicated that 66% of participants perceived that their walking had improved. However, there was a significant relationship between GRCS and performance on walking tests for the 10 m walk test with shoes off (p = 0.01) and timed up and go test (p = 0.02) only. Conclusion: Commonly used walking tests may not be responsive to change following BoNT injection. The small ES suggest that BoNT has a modest effect on walking ability. Tests of walking performance may not be sufficient to capture all clinically relevant changes in walking ability following BoNT injection of the lower limb.
引用
收藏
页码:959 / 967
页数:9
相关论文
共 55 条
[1]
Has botulinum toxin type A a place in the treatment of spasticity in spinal cord injury patients? [J].
Al-Khodairy, AT ;
Gobelet, C ;
Rossier, AB .
SPINAL CORD, 1998, 36 (12) :854-858
[2]
[Anonymous], NEURAL REGENERATION
[3]
Effects of footwear on measurements of balance and gait in women between the ages of 65 and 93 years [J].
Arnadottir, SA ;
Mercer, VS .
PHYSICAL THERAPY, 2000, 80 (01) :17-27
[4]
A SINGLE-BLINDED, RANDOMIZED PILOT STUDY OF BOTULINUM TOXIN TYPE A COMBINED WITH NON-PHARMACOLOGICAL TREATMENT FOR SPASTIC FOOT [J].
Baricich, Alessio ;
Carda, Stefano ;
Bertoni, Michele ;
Maderna, Luca ;
Cisari, Carlo .
JOURNAL OF REHABILITATION MEDICINE, 2008, 40 (10) :870-872
[5]
Low-dose botulinum toxin with short-term electrical stimulation in poststroke spastic drop foot - A preliminary study [J].
Bayram, S ;
Sivrioglu, K ;
Karli, N ;
Ozcan, O .
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION, 2006, 85 (01) :75-81
[6]
Many faces of the minimal clinically important difference (MCID): a literature review and directions for future research [J].
Beaton, DE ;
Boers, M ;
Wells, GA .
CURRENT OPINION IN RHEUMATOLOGY, 2002, 14 (02) :109-114
[7]
Focal spasticity therapy with botulinum toxin: Effects on function, activities of daily living and pain in 100 adult patients [J].
Bergfeldt, U ;
Borg, K ;
Kullander, K ;
Julin, P .
JOURNAL OF REHABILITATION MEDICINE, 2006, 38 (03) :166-171
[8]
Biomechanical transformation of the gastroc-soleus muscle with botulinum toxin A in children with cerebral palsy [J].
Boyd, RN ;
Pliatsios, V ;
Starr, R ;
Wolfe, R ;
Graham, HK .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2000, 42 (01) :32-41
[9]
Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerebral palsy [J].
Boyd, RN ;
Graham, HK .
EUROPEAN JOURNAL OF NEUROLOGY, 1999, 6 :S23-S35
[10]
A randomised, double blind, placebo controlled trial of botulinum toxin in the treatment of spastic foot in hemiparetic patients [J].
Burbaud, P ;
Wiart, L ;
Dubos, JL ;
Gaujard, E ;
Debelleix, X ;
Joseph, PA ;
Mazaux, JM ;
Bioulac, B ;
Barat, M ;
Lagueny, A .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1996, 61 (03) :265-269