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Clin Neurol Neurosurg. 2012 Jun;114(5):498-501. doi: 10.1016/j.clineuro.2012.03.014. Epub 2012 Apr 4.

Modification of altered ankle motor control after stroke using focal application of botulinum toxin type A.

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  • 1Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital, Linkou and Chang Gung University College of Medicine, Tao-Yuan County, Taiwan.



Blinded, placebo-controlled, prospective clinical trial.


To examine the effects of botulinum toxin type A (BTX-A) injections into plantar flexor muscles in stroke patients with equinovarus gait.


15 post-stroke and 10 matched neurologically intact subjects.


Modified Ashworth Scale (MAS) and Fugl-Meyer assessment of physical function scale scores along with surface EMG collected before and up to 12 weeks after BTX-A injections to plantar flexor muscle motor points in stroke subjects. Saline placebo injections were performed in a subset of stroke subject group.


MAS scores were decreased at 4, 8 and 12 weeks but F-M scores did not improve until 12 weeks post injection. Multi-muscle EMG patterns showed the return of volitional dorsiflexor activity in 11 and a decrease of antagonistic and distant coactivation in all but one of the 15.


BTX-A is effective in reducing antagonistic and distant muscle activation that impedes volitional dorsiflexion.

Copyright © 2012 Elsevier B.V. All rights reserved.

[PubMed - indexed for MEDLINE]
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