Functional outcome following Botulinum toxin A injection to reduce spastic equinus in adults with traumatic brain injury

Primary objective : The aim of this study was to assess the effect of Botulinum toxin A in the management of spastic equinus resulting from traumatic brain injury. Research design : A before-after intervention design was used without controls. Methods and procedures : Subjects were seven patients suffering from traumatic brain injury of average duration 14 (4-38) months as a result of motor vehicle trauma, who had spastic equinus interfering with gait. Experimental intervention : The patients were treated with injections of Botulinum toxin A into the spastic calf muscles: gastrocnemius, soleus and tibialis posterior. Assessments were made pre-injection and at 2 weeks and 3 months post-injection. Main outcome and results : At the end of the 3-month period, all patients showed a significant improvement in gait velocity, cadence and stride length. Conclusions : The findings suggest that Botulinum toxin A may be useful in the management of spastic equinus following traumatic brain injury.