Diagnostic nerve block in prediction of outcome of botulinum toxin treatment for spastic equinovarus foot after stroke: A retrospective observational study
| Autor: | Elisa Battistuzzi, Alessandro Picelli, Marialuisa Gandolfi, Nicola Smania, Daniele Munari, Mirko Filippetti, Angela Modenese |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Lidocaine diagnosis Modified Ashworth scale medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation RM1-950 Injections Intramuscular medicine Spastic Humans Spasticity botulinum toxin Botulinum Toxins Type A Tibial nerve Stroke muscle spasticity Retrospective Studies equinus deformity business.industry Rehabilitation Nerve Block General Medicine Middle Aged medicine.disease Botulinum toxin Clubfoot Treatment Outcome Neuromuscular Agents Anesthesia Nerve block Female Therapeutics. Pharmacology medicine.symptom business medicine.drug |
| Zdroj: | Journal of Rehabilitation Medicine, Vol 52, Iss 6, p jrm00069 (2020) |
| ISSN: | 1651-2081 |
| Popis: | Objective To evaluate the role of diagnostic nerve block in predicting the outcome of subsequent botulinum toxin type A treatment for spastic equinovarus foot due to chronic stroke. Design Retrospective observational study. Patients Fifty chronic stroke patients with spastic equinovarus foot. Methods Each patient was given diagnostic tibial nerve block (lidocaine 2% perineural injection) assessment followed by botulinum toxin type A inoculation into the same muscles as had been targeted by the nerve block. All patients were evaluated before diagnostic nerve block, after the nerve block, and 4 weeks after botulinum toxin injection. Outcomes were ankle dorsiflexion passive range of motion of the affected side, and calf muscle spasticity, measured with the modified Ashworth scale and the Tardieu Scale. Results Significant improvements were measured after diagnostic nerve block and botulinum toxin injection compared with the baseline condition. Diagnostic nerve block led to significantly greater improvements in all outcomes than botulinum toxin injection. Conclusion This study confirmed diagnostic nerve block as a valuable screening tool in deciding whether to treat spastic equinovarus with botulinum toxin. However, the results support the evidence that diagnostic nerve block results in a greater reduction in muscle overactivity than does botulinum toxin type A in patients with spastic equinovarus due to stroke. |
| Databáze: | OpenAIRE |
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