Quantitative assessment for flexed-elbow deformity during gait following botulinum toxin A treatment

Hiroki Tanikawa, Hitoshi Kagaya, Keisuke Inagaki, Yusuke Kotsuji, Keita Suzuki, Kenta Fujimura, Masahiko Mukaino, Satoshi Hirano, Eiichi Saito, Yoshikiyo Kanada

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The effect of botulinum toxin A (BoNTA) injection on flexed-elbow deformity is usually evaluated using the Modified Ashworth Scale (MAS), but only with the muscle tone at rest. Some patients show the flexed-elbow deformity during gait despite low muscle tone at rest. Objective: This study aimed to evaluate the effect of BoNTA injection on flexed-elbow deformity during gait using a three-dimensional motion analysis system. Methods: Twenty stroke patients with spastic flexed-elbow deformity during gait received BoNTA injections into the upper limb muscles. The MAS score of the elbow flexors, passive elbow range of motion, comfortable overground gait velocity, and elbow flexion angle during treadmill gait were evaluated just before and 2, 6, and 12 weeks after the injection. Twenty-five healthy subjects were also recruited to provide a normal reference of the elbow flexion angle. Results: The MAS scores at 2, 6 and 12 weeks after the injection were significantly lower than that before the injection. Some patients showed no spasticity at rest but an obviously flexed elbow during gait. The elbow flexion angles during gait at 2 and 6 weeks after the injection were significantly lower than that before the injection. Conclusions: BoNTA injections to the upper limb muscles reduced muscle tone at rest and flexed-elbow deformity during gait. However, the elbow flexion angle during gait returned to its pre-injection level sooner than the muscle tone at rest. We strongly recommend evaluating muscle tone during motion and at rest, preferably using three-dimensional motion analysis since it can objectively detect small changes.

Original languageEnglish
Pages (from-to)409-414
Number of pages6
JournalGait and Posture
Volume62
DOIs
Publication statusPublished - 01-05-2018

Fingerprint

Type A Botulinum Toxins
Elbow
Gait
Injections
Muscles
Therapeutics
Upper Extremity
Muscle Spasticity
Articular Range of Motion
Healthy Volunteers
Stroke

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation

Cite this

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title = "Quantitative assessment for flexed-elbow deformity during gait following botulinum toxin A treatment",
abstract = "Background: The effect of botulinum toxin A (BoNTA) injection on flexed-elbow deformity is usually evaluated using the Modified Ashworth Scale (MAS), but only with the muscle tone at rest. Some patients show the flexed-elbow deformity during gait despite low muscle tone at rest. Objective: This study aimed to evaluate the effect of BoNTA injection on flexed-elbow deformity during gait using a three-dimensional motion analysis system. Methods: Twenty stroke patients with spastic flexed-elbow deformity during gait received BoNTA injections into the upper limb muscles. The MAS score of the elbow flexors, passive elbow range of motion, comfortable overground gait velocity, and elbow flexion angle during treadmill gait were evaluated just before and 2, 6, and 12 weeks after the injection. Twenty-five healthy subjects were also recruited to provide a normal reference of the elbow flexion angle. Results: The MAS scores at 2, 6 and 12 weeks after the injection were significantly lower than that before the injection. Some patients showed no spasticity at rest but an obviously flexed elbow during gait. The elbow flexion angles during gait at 2 and 6 weeks after the injection were significantly lower than that before the injection. Conclusions: BoNTA injections to the upper limb muscles reduced muscle tone at rest and flexed-elbow deformity during gait. However, the elbow flexion angle during gait returned to its pre-injection level sooner than the muscle tone at rest. We strongly recommend evaluating muscle tone during motion and at rest, preferably using three-dimensional motion analysis since it can objectively detect small changes.",
author = "Hiroki Tanikawa and Hitoshi Kagaya and Keisuke Inagaki and Yusuke Kotsuji and Keita Suzuki and Kenta Fujimura and Masahiko Mukaino and Satoshi Hirano and Eiichi Saito and Yoshikiyo Kanada",
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Quantitative assessment for flexed-elbow deformity during gait following botulinum toxin A treatment. / Tanikawa, Hiroki; Kagaya, Hitoshi; Inagaki, Keisuke; Kotsuji, Yusuke; Suzuki, Keita; Fujimura, Kenta; Mukaino, Masahiko; Hirano, Satoshi; Saito, Eiichi; Kanada, Yoshikiyo.

In: Gait and Posture, Vol. 62, 01.05.2018, p. 409-414.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantitative assessment for flexed-elbow deformity during gait following botulinum toxin A treatment

AU - Tanikawa, Hiroki

AU - Kagaya, Hitoshi

AU - Inagaki, Keisuke

AU - Kotsuji, Yusuke

AU - Suzuki, Keita

AU - Fujimura, Kenta

AU - Mukaino, Masahiko

AU - Hirano, Satoshi

AU - Saito, Eiichi

AU - Kanada, Yoshikiyo

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: The effect of botulinum toxin A (BoNTA) injection on flexed-elbow deformity is usually evaluated using the Modified Ashworth Scale (MAS), but only with the muscle tone at rest. Some patients show the flexed-elbow deformity during gait despite low muscle tone at rest. Objective: This study aimed to evaluate the effect of BoNTA injection on flexed-elbow deformity during gait using a three-dimensional motion analysis system. Methods: Twenty stroke patients with spastic flexed-elbow deformity during gait received BoNTA injections into the upper limb muscles. The MAS score of the elbow flexors, passive elbow range of motion, comfortable overground gait velocity, and elbow flexion angle during treadmill gait were evaluated just before and 2, 6, and 12 weeks after the injection. Twenty-five healthy subjects were also recruited to provide a normal reference of the elbow flexion angle. Results: The MAS scores at 2, 6 and 12 weeks after the injection were significantly lower than that before the injection. Some patients showed no spasticity at rest but an obviously flexed elbow during gait. The elbow flexion angles during gait at 2 and 6 weeks after the injection were significantly lower than that before the injection. Conclusions: BoNTA injections to the upper limb muscles reduced muscle tone at rest and flexed-elbow deformity during gait. However, the elbow flexion angle during gait returned to its pre-injection level sooner than the muscle tone at rest. We strongly recommend evaluating muscle tone during motion and at rest, preferably using three-dimensional motion analysis since it can objectively detect small changes.

AB - Background: The effect of botulinum toxin A (BoNTA) injection on flexed-elbow deformity is usually evaluated using the Modified Ashworth Scale (MAS), but only with the muscle tone at rest. Some patients show the flexed-elbow deformity during gait despite low muscle tone at rest. Objective: This study aimed to evaluate the effect of BoNTA injection on flexed-elbow deformity during gait using a three-dimensional motion analysis system. Methods: Twenty stroke patients with spastic flexed-elbow deformity during gait received BoNTA injections into the upper limb muscles. The MAS score of the elbow flexors, passive elbow range of motion, comfortable overground gait velocity, and elbow flexion angle during treadmill gait were evaluated just before and 2, 6, and 12 weeks after the injection. Twenty-five healthy subjects were also recruited to provide a normal reference of the elbow flexion angle. Results: The MAS scores at 2, 6 and 12 weeks after the injection were significantly lower than that before the injection. Some patients showed no spasticity at rest but an obviously flexed elbow during gait. The elbow flexion angles during gait at 2 and 6 weeks after the injection were significantly lower than that before the injection. Conclusions: BoNTA injections to the upper limb muscles reduced muscle tone at rest and flexed-elbow deformity during gait. However, the elbow flexion angle during gait returned to its pre-injection level sooner than the muscle tone at rest. We strongly recommend evaluating muscle tone during motion and at rest, preferably using three-dimensional motion analysis since it can objectively detect small changes.

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