Article

OBJECTIVE: To investigate the effect of different adjunctive treatments after
botulinum toxin type A.
DESIGN: Single-blind, randomized trial, with three-month
follow-up. Secondary rehabilitative care. SUBJECTS: Convenience sample
of 69 chronic hemiplegic adult patients with spastic equinus foot. INTERVENTIONS:
Following botulinum toxin type A injection at the plantar flexors, patients were
randomly assigned to three groups and treated with either taping, casting or
stretching for one week, and with stretching and gait training for the next week.
OUTCOME MEASURES: Modified Ashworth Scale at plantar flexors, passive range of
motion at the ankle, six-minute walking test, 10-metre walking test, Functional
Ambulation Categories, ankle dorsiflexor strength were evaluated before treatment
(t(0)) at 20 days (t(1)) and 90 days (t(2)) after treatment. RESULTS: At t(1)
only the taping and casting groups showed significant improvements in Modified
Ashworth Scale, six-minute walking test, 10-metre walking test and passive range
of motion (P < 0.02). At t(2), while the results were maintained in the casting
group, only six-minute walking test and Modified Ashworth Scale were still
significantly improved in the taping group. Ankle dorsiflexor strength and
Functional Ambulation Categories did not change in any of the groups at any time.
At t(2) the casting group performed better than the taping and stretching groups
at Modified Ashworth Scale and passive range of motion, and better than the
stretching group at six-minute walking test (P < 0.02). CONCLUSIONS: Combining
botulinum toxin type A to the ankle plantar flexors with casting or taping gives
better and longer lasting results than with stretching alone.

Langue : ANGLAIS