Efficacy of Botulinum Toxin A Treatment for Pes Varus during Gait

Hiroki Tanikawa, Hitoshi Kagaya, Eiichi Saitoh, Kenichi Ozaki, Satoshi Hirano, Norihide Itoh, Junya Yamada, Yoshikiyo Kanada

Research output: Contribution to journalArticle

Abstract

Background The efficacy of botulinum toxin A (BoNTA) injection on spasticity is usually measured using Modified Ashworth Scale (MAS), but this only evaluates muscle tone at rest and has poor reliability. There are no reports that quantitatively evaluate pes varus during walking after botulinum treatment. The purpose of this study was to evaluate the efficacy of BoNTA injection on pes varus during gait using 3-dimensional motion analysis. Methods Twenty-four hemiplegic patients with spastic pes varus deformity during gait received BoNTA injection into lower limb muscles. MAS score, comfortable overground gait velocity, and pes varus angle during treadmill walking were evaluated before, 2, 6, and 12 weeks after the injection. Five healthy subjects were also recruited to develop the pes varus/valgus angle as a normal reference. Results The median MAS scores were significantly lower at 2 and 6 weeks after the injection. The maximum pes varus angle during the swing phase was significantly lower at 2, 6, and 12 weeks after the injection. It was significantly lower at 6 weeks after the injection during stance phase. The comfortable overground gait velocity was also improved after the injection. However, 2 patients experienced pain during gait and their pes varus angle increased during the follow-up period. Conclusions BoNTA injection improved pes varus angle during gait. Evaluating motion in addition to spasticity at rest is recommended because improvements in limb function do not always parallel improvements in spasticity at rest.

Original languageEnglish (US)
Pages (from-to)2416-2422
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number10
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

Keywords

  • Botulinum toxin A
  • gait analysis
  • hemiplegia
  • pes varus
  • spasticity
  • treadmill

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

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    Tanikawa, H., Kagaya, H., Saitoh, E., Ozaki, K., Hirano, S., Itoh, N., Yamada, J., & Kanada, Y. (2015). Efficacy of Botulinum Toxin A Treatment for Pes Varus during Gait. Journal of Stroke and Cerebrovascular Diseases, 24(10), 2416-2422. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.06.035