Yoshitaka Wada, MD, Naruhito Otsuka, MD, PhD, Nobuyuki Kawate, MD, PhD, Hiroshi Moriyama, DDS, PhD, Hiromitsu Ezure, DDS, DDSc, PhD, Yuriko Inoue, PhD
Jpn J Compr Rehabil Sci 11: 85-90, 2020
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.
Key words: spasticity, botulinum therapy, equinovarus, stroke, plantar contact area