Email this article Botulinum toxin treatment of lower extremity spasticity
- Authors: Khat’kova S.E.1,2, Akulov M.A.3, Orlova O.R.4, Usachev D.Y.3, Orlova A.S.4, Krylova L.V.5
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Affiliations:
- Treatment and Rehabilitation Center, Ministry of Health of Russia
- A.I. Burnazyan Federal Medical and Biological Center, FMBA of Russia
- N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of Russia
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
- Hospital for Was Veterans
- Issue: Vol 7, No 3 (2017)
- Pages: 21-35
- Section: LECTURES AND REVIEWS
- Published: 07.11.2017
- URL: https://nmb.abvpress.ru/jour/article/view/210
- DOI: https://doi.org/10.17650/2222-8721-2017-7-3-21-35
- ID: 210
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Abstract
The article reviews the current concept of lower extremity spasticity, which is a frequent disabling consequence of stroke. Gait biomechanics, step cycle and main pathologic patterns of lower extremity are described (hip adduction, knee flexion, knee extension, foot plantar flexion, equinovarus foot position, toes flexion, hallux extension), including muscles involved in the pathological process. Additionally the article contains detailed information on pathologic principles of lower extremity spasticity development. Special focus is given to sarcomeregenesis as an essential element of the development of potential conditions for muscle tissue adaptation to a new state and restoration of muscle length and strength. At present Botulinum toxin A (BTA) is used in a complex spasticity management programs. The results of clinical studies performed in the last decade supporting the efficacy of Botox® (Onabotulinumtoxin A) in the treatment of spasticity are reviewed. Effective BTA doses are proposed. Authors came to the conclusion that BTA as a part of complex rehabilitation in patients with poststroke spasticity of lower extremity promotes treatment efficacy due to a decrease of muscle tone and increase of range of movements in the joints. BTA should be regarded as an essential part of standard rehabilitation programs. Further studies to define optimal muscles for intervention, BTA doses and rehabilitation schemes are still needed.
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About the authors
S. E. Khat’kova
Treatment and Rehabilitation Center, Ministry of Health of Russia;A.I. Burnazyan Federal Medical and Biological Center, FMBA of Russia
Author for correspondence.
Email: hse15@mail.ru
Russian Federation
M. A. Akulov
N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of Russia
Email: hse15@mail.ru
Russian Federation
O. R. Orlova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Email: hse15@mail.ru
Russian Federation
D. Yu. Usachev
N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of Russia
Email: hse15@mail.ru
Russian Federation
A. S. Orlova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Email: hse15@mail.ru
Russian Federation
L. V. Krylova
Hospital for Was Veterans
Email: hse15@mail.ru
Russian Federation
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