Color Doppler ultrasound-guided botulinum toxin type A injection combined with an ankle foot brace for treating lower limb spasticity after a stroke

X.-D. Ding, G.-B. Zhang, H.-X. Chen, W. Wang, J.-H. Song, D.-G. Fu

Department of Neurology, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei Province, China. dingxd1018@163.com

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• Neurology

OBJECTIVE: To explore the effectiveness of the color Doppler ultrasound-guided botulinum toxin type A (BTX-A) injection combined with an ankle foot brace (AFO) for treating lower limb spasticity after a stroke.

PATIENTS AND METHODS: A total of 103 post-stroke patients with lower limb spasticity were divided into three groups: the control group treated with conventional therapy and rehabilitation training, the observation group treated with conventional therapy, rehabilitation training and botulinum toxin type A injection, the treatment group treated with AFO plus the same treatment received by the observation group. The muscle spasms were evaluated using the Clinic Spasticity Influx (CSI), movement with the Fugl-Meyer Assessment (FMA), dynamic and static balance with the Berg Balance Scale (BBS), and daily life activities with the Functional Independence Measure (FIM), respectively.

RESULTS: Compared the first month after treatment with the prior treatment, there were significant differences in CSI, FMA and FIM scores in both control group and the observation group (p < 0.05). However, no differences were noticed in the control group (p > 0.05). Compared the third and sixth month after treatment with prior treatment, there were significant differences in these three groups (p < 0.05). In terms of treatment time, the BBS scores were always higher in all three groups after one month, three months and six months treatment than prior treatment (p < 0.05), and there were significant differences in third month and sixth month after treatment compared with the first month treatment (p < 0.05). Compared the third month after treatment with the sixth month, there were significant differences in all three groups (p < 0.05).

CONCLUSIONS: The color Doppler ultrasound-guided BTX-A injection combined with AFO can effectively promote patients with post-stroke lower limb spasticity in lower limb muscle spasm, movement, balance and daily life activities.

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