Article

This study aimed to compare the efficacy of onabotulinum toxin A
(onabot) injection into the rectus femoris muscle with that of placebo in the
treatment of hemiplegic stroke patients presenting with stiff-knee gait. DESIGN:
Twenty-five chronic hemiparetic stroke patients presenting with a stiff-knee gait
were included in this study. Fifteen patients received 100-125 U of onabot, and
10 patients received placebo into the rectus femoris muscle.
Three-dimensional
gait analysis, energy expenditure, 10-m and 6-min walk tests, and spasticity
level of the rectus femoris were evaluated at baseline and 2 mos posttreatment.
RESULTS: The mean age of patients who received onabot was 53.86 +/- 14.74 yrs and
of those who received placebo was 59.00 +/- 8.11 yrs.
At study onset, groups were
similar with respect to all parameters (P > 0.05). We observed significant
improvement in knee flexion (7 degrees average) during swing and a reduction in
energy cost of 0.8-J/kg per meter response to injection of 100-125 U of onabot
into the rectus femoris muscle. Onabot treatment significantly reduced muscle
tone and improved knee kinematics, energy expenditure during walking, and
functional assessments at 2 mos (P < 0.05); however, placebo had no effects on
these parameters. Moreover, maximum knee flexion at swing and energy expenditure
in the onabot group was significantly better than placebo at 2 mos (P < 0.05).
CONCLUSIONS: Our results showed the superiority of onabot over placebo in
increasing knee flexion during swing phase and decreasing energy expenditure. The
application of onabot into the rectus femoris muscle in stroke patients who
presented with stiff-knee gait may be a treatment option to provide independent,
safe, and less tiring ambulation.

Langue : ANGLAIS