[Clinical effect of ultrasound combined with anatomy-measure guidance botulinum toxin type A injection in poststroke patients with spasticity]

Abstract

Objective: To evaluate the clinical efficacies of botulinum toxin type A (BTX-A) injection under ultrasonic guidance and body surface positioning in poststroke patients with lower extremities spasticity.

Methods: From January 2009 to January 2011, a total of 18 patients with stroke-related spasticity in lower extremities were recruited at Third Affiliated Hospital of Sun Yat-sen University. Under the guide of color Doppler ultrasound and body surface positioning, BTX-A was injected into multi-points of muscles. The outcome after BTX-A injection was assessed by modified Ashworth scale (MAS), passive range of movement (PROM), 10-meter walking test (10 MWT) and Berg balance scale (BBS). Assessments were performed at baseline, Day 3, Weeks 1, 2, 4 and 12 post-injection respectively.

Results: Compared the scores of MAS (MAS(pre-treatment) 2.6 ± 0.5, MAS(post-treatment) 1.9 ± 0.2 - 1.1 ± 0.3 score), PROM (PROM(pre-treatment) 7.2 ± 2.4°, PROM(post-treatment) 12.3 ± 2.0 - 18.6 ± 2.2°) between baseline and follow-up at Weeks 1, 2, 4 and 12 post-treatment, there were significant statistical differences (P < 0.05).10 MW (10 MWT(pre-treatment) 55.1 ± 5.2 s, 10 MWT(post-treatment) 48.6 ± 4.2 - 42.9 ± 3.8 s) and BBS (BBS(pre-treatment) 34.7 ± 5.1, BBS(post-treatment) 39.9 ± 4.9 - 45.8 ± 2.1 score) improved greatly at Weeks 2, 4 and 12 post-treatment.

Conclusion: Ultrasonic guidance and body surface positioning is an accurate positioning modality of using BTX-A for treating the spasticity of lower extremities.