Effect of two doses of botulinum toxin type A on maximum plantar contact area in hemiplegic stroke patients with pes equinovarus

Abstract

Inoue Y. Effect of two doses of botulinum toxin type A on maximum plantar contact area in hemiplegic stroke patients with pes equinovarus. Jpn J Compr Rehabil Sci 2020; 11: 85-90. Objectives: To quantitatively demonstrate the therapeutic effects of two doses of botulinum toxin type A (BoNT-A) on pes equinovarus in hemiplegic stroke patients. Methods: The subjects of this study included eight chronic stroke patients who received two BoNT-A doses (mean dose interval: 136.0 (10.5) days) from April 2011 to March 2013 and underwent a sheet-type weight-bearing lower limb test. The maximum plantar contact area on the paralyzed side, ratio of maximum plantar contact areas on the paralyzed and nonparalyzed sides, and Modified Ashworth Scale (MAS) were measured before BoNT-A administration and 4 weeks after both the first and second doses. Results: A significant increase in the maximum plantar contact area was observed after administration of the second dose compared to that of the first dose on the paralyzed side. Additionally, a significant increase was observed in the ratio of paralyzed/non-paralyzed maximum plantar contact areas after the administration of both the first and second doses compared to that before BoNT-A administration. MAS was observed to decline significantly after the administration of both the first and second doses compared to that prior to BoNT-A administration. Conclusions: We suggest that comparison of the plantar contact area is useful for assessing the therapeutic effects of BoNT-A doses on pes equinovarus in hemiplegic stroke patients.