Article

The aim of this study was to compare the clinical outcomes of manual
needle placement, electrical stimulation, and ultrasonography-guided techniques
for botulinum toxin injection into the gastrocnemius of adults with spastic
equinus after stroke. DESIGN: After randomization into three groups, each patient
received the same dose of botulinum toxin type A into the lateral and medial head
of the gastrocnemius muscle (OnabotulinumtoxinA, 100U per head) of the affected
leg. The manual needle placement group (n = 15) underwent injections using
anatomic landmarks and palpation; the electrical stimulation group (n = 15)
received injections with electrical stimulation guidance; and the ultrasonography
group (n = 17) was injected under sonographic guidance. The modified Ashworth
scale, the Tardieu scale, and the ankle passive range of motion were measured at
baseline and 1 mo after injection. Nonparametric statistical analysis was used.
RESULTS: One month after injection, the modified Ashworth scale improved better
in the ultrasonography group than in the manual needle placement group (P = 0.008). The ankle passive range of motion improved better in the ultrasonography
group than in the electrical stimulation (P = 0.004) and manual needle placement
(P < 0.001) groups. No difference was found between groups for the Tardieu scale.
CONCLUSIONS: Ultrasonography-guided injection technique could improve the
clinical outcome of botulinum toxin injections into the gastrocnemius of adults
with spastic equinus.

Langue : ANGLAIS