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Clinical and instrumental gait assessment in adult with cerebral palsy and gluteus medius anterior fibers spasticity before and after local treatment with botulinum toxin
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Y.G. Yi et al. / Annals of Physical and Rehabilitation Medicine 61S (2018) e309–e433
Fig. 1 Selection of primary goal areas in sub-populations of patients with and without shoulder injections.
Fig. 2 Mean change from baseline to Week 4 in passive range of motion (XV1 ), angle of catch (XV3 ) and spasticity angle (X) in shoulder muscles at the last injection cycle.
spatiotemporal gait parameters in FD pre- and post-botulinum toxin injection along with other lower limb functional outcomes. Material and method Fourteen (14) adult patients with FD were assessed in the multidisciplinary spasticity clinic pre-and postinjection of botulinum toxin. We conducted gait analysis in the Gait rite system besides recording Fan Marsden Dystonia Scale (FMDS), Visual Analog Scale (VAS) of pain, Berg Balance Score (BBS), Unified Parkinson’s Disease Rating Scale - Lower Limb Score (UPDRSLL), Timed Up and Go (TUG) test and the Goal Attainment Scale (GAS). Results We used the random effects panel data estimators in Stata to examine the difference from before the intervention to after to assess whether there was significant change in gait parameters. In all models the test for the time effect was adjusted for age, sex, and side (left or right). We found that stride length increased significantly in both the affected (P = 0.021) and unaffected leg (0.010) after treatment, and that the improvement in stride length was roughly the same in each leg. Similar results were found for step length (P = 0.021) with improvement in the step length differential (P = 0.016). The improvement in the lower limb functional outcomes were also significant (FMDS, P < 0.001, VAS, P < 0.001, TUG, P < 0.001, BBG, P = 0.001, UPDRSLL, P < 0.001, GAS, P < 0.001, GV, P = 028) except Cadence, P = 0.367. Conclusion BT is effective in improving walking in foot dystonia as evidenced through gait analysis and improved lower limb functional outcomes. Keywords Gait; Foot dystonia; Botulinum toxin Disclosure of interest The author declares that he has no competing interest. https://doi.org/10.1016/j.rehab.2018.05.857 ISPR8-0293
Clinical and instrumental gait assessment in adult with cerebral palsy and gluteus medius anterior fibers spasticity before and after local treatment with botulinum toxin
F. Babany ∗ , P. Thoumie Hôpital Rothschild, Neuro-orthopedic rehabilitation, Paris, France ∗ Corresponding author. E-mail address: fl[email protected] (F. Babany) Fig. 3 Mean change from baseline to Week 4 in Modified Frenchay Score for active function of shoulder muscles after each injection cycle. Data are the mean (standard deviation) change from baseline to Week 4 of last injection cycle to include shoulder muscles.
conference attendance fees from Ipsen. Philippe Picaut, Pascal Maisonobe and Jovita Balcaitiene are employees of Ipsen. https://doi.org/10.1016/j.rehab.2018.05.856 ISPR8-0250
Gait analysis and other functional parameters in foot dystonia following botulinum toxin A injection A. Datta Gupta The Queen Elizabeth Hospital, Rehabilitation Medicine, Adelaide, Australia E-mail address: [email protected] Introduction/Background Foot dystonia (FD) is a movement disorder characterised by sustained or intermittent muscle contractions causing abnormal, often repetitive movements resulting in pain, spasm and difficulty in walking. The most effective treatment for FD is botulinum toxin injection. The spatiotemporal gait analysis in Gait Rite is well validated and may help clinicians to record the outcomes more objectively. In this paper, we discuss the
Introduction/Background Gait with internal hip rotation is often observed in adult with cerebral palsy both in diplegic and hemiplegic forms. Walking disabilities could be the consequence of gluteus medius anterior fibers spasticity. Material and method A monocentric prospective pilot study was to assess the clinical and paraclinical progression of hip internal rotation, velocity and Functional Ambulation Performance (FAP) score index. We included eight patients (nine hips) with a follow-up to five weeks. Clinical (questionnaire, spasticity) and instrumental ® (walk on “GAITRite ) assessments were performed at the beginning and at the end of the study. Results The FAP was significantly higher (10%) after botulinum toxin (80 to 87, P < 0.05). There was no significant impact on internal rotation and velocity. Patients felt better with a fluider gait and less fall. Conclusion Botulinum toxin improved gait performances in adult with cerebral palsy and gluteus medius anterior fibers spasticity. A randomized prospective multicentric study is required to confirm the preliminary results and to assess the impact of quality of life. Keywords Cerebral palsy; Gluteus medius anterior fibers spasticity; Functional Ambulation Performance (FAP) Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.858
Y.G. Yi et al. / Annals of Physical and Rehabilitation Medicine 61S (2018) e309–e433
Fig. 1 Selection of primary goal areas in sub-populations of patients with and without shoulder injections.
Fig. 2 Mean change from baseline to Week 4 in passive range of motion (XV1 ), angle of catch (XV3 ) and spasticity angle (X) in shoulder muscles at the last injection cycle.
spatiotemporal gait parameters in FD pre- and post-botulinum toxin injection along with other lower limb functional outcomes. Material and method Fourteen (14) adult patients with FD were assessed in the multidisciplinary spasticity clinic pre-and postinjection of botulinum toxin. We conducted gait analysis in the Gait rite system besides recording Fan Marsden Dystonia Scale (FMDS), Visual Analog Scale (VAS) of pain, Berg Balance Score (BBS), Unified Parkinson’s Disease Rating Scale - Lower Limb Score (UPDRSLL), Timed Up and Go (TUG) test and the Goal Attainment Scale (GAS). Results We used the random effects panel data estimators in Stata to examine the difference from before the intervention to after to assess whether there was significant change in gait parameters. In all models the test for the time effect was adjusted for age, sex, and side (left or right). We found that stride length increased significantly in both the affected (P = 0.021) and unaffected leg (0.010) after treatment, and that the improvement in stride length was roughly the same in each leg. Similar results were found for step length (P = 0.021) with improvement in the step length differential (P = 0.016). The improvement in the lower limb functional outcomes were also significant (FMDS, P < 0.001, VAS, P < 0.001, TUG, P < 0.001, BBG, P = 0.001, UPDRSLL, P < 0.001, GAS, P < 0.001, GV, P = 028) except Cadence, P = 0.367. Conclusion BT is effective in improving walking in foot dystonia as evidenced through gait analysis and improved lower limb functional outcomes. Keywords Gait; Foot dystonia; Botulinum toxin Disclosure of interest The author declares that he has no competing interest. https://doi.org/10.1016/j.rehab.2018.05.857 ISPR8-0293
Clinical and instrumental gait assessment in adult with cerebral palsy and gluteus medius anterior fibers spasticity before and after local treatment with botulinum toxin
F. Babany ∗ , P. Thoumie Hôpital Rothschild, Neuro-orthopedic rehabilitation, Paris, France ∗ Corresponding author. E-mail address: fl[email protected] (F. Babany) Fig. 3 Mean change from baseline to Week 4 in Modified Frenchay Score for active function of shoulder muscles after each injection cycle. Data are the mean (standard deviation) change from baseline to Week 4 of last injection cycle to include shoulder muscles.
conference attendance fees from Ipsen. Philippe Picaut, Pascal Maisonobe and Jovita Balcaitiene are employees of Ipsen. https://doi.org/10.1016/j.rehab.2018.05.856 ISPR8-0250
Gait analysis and other functional parameters in foot dystonia following botulinum toxin A injection A. Datta Gupta The Queen Elizabeth Hospital, Rehabilitation Medicine, Adelaide, Australia E-mail address: [email protected] Introduction/Background Foot dystonia (FD) is a movement disorder characterised by sustained or intermittent muscle contractions causing abnormal, often repetitive movements resulting in pain, spasm and difficulty in walking. The most effective treatment for FD is botulinum toxin injection. The spatiotemporal gait analysis in Gait Rite is well validated and may help clinicians to record the outcomes more objectively. In this paper, we discuss the
Introduction/Background Gait with internal hip rotation is often observed in adult with cerebral palsy both in diplegic and hemiplegic forms. Walking disabilities could be the consequence of gluteus medius anterior fibers spasticity. Material and method A monocentric prospective pilot study was to assess the clinical and paraclinical progression of hip internal rotation, velocity and Functional Ambulation Performance (FAP) score index. We included eight patients (nine hips) with a follow-up to five weeks. Clinical (questionnaire, spasticity) and instrumental ® (walk on “GAITRite ) assessments were performed at the beginning and at the end of the study. Results The FAP was significantly higher (10%) after botulinum toxin (80 to 87, P < 0.05). There was no significant impact on internal rotation and velocity. Patients felt better with a fluider gait and less fall. Conclusion Botulinum toxin improved gait performances in adult with cerebral palsy and gluteus medius anterior fibers spasticity. A randomized prospective multicentric study is required to confirm the preliminary results and to assess the impact of quality of life. Keywords Cerebral palsy; Gluteus medius anterior fibers spasticity; Functional Ambulation Performance (FAP) Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.858