Departmental Bulletin Paper Comparison of Plantar Pressure and Plantar Contact Area before and after Botulinum Toxin Type A(BoNT-A)Therapy in Stroke Patients with Lower Limb Spasticity

KAWATE Nobuyuki:筆頭著者:責任著者  ,  MATSUMOTO Miyuki  ,  IIJIMA Shinsuke

29 ( 2 )  , pp.193 - 200 , 2017-06 , Showa University Society
ISSN:0915-6380
Description
The effectiveness of botulinum toxin type A(BoNT-A)therapy for reducing muscle spasticity has been reported. We examined changes in the plantar contact area and plantar pressure after BoNT-A injection therapy in stroke patients with spastic hemiparesis. The study participants were 12 male hemiparetic stroke patients treated in our outpatient clinic(right hemiparesis, 7; left, 5), who were able to walk without orthoses. They were requested to walk barefoot at their normal walking speed on a sheet with pressure measurement sensors, before, and at one and three months after BoNT-A therapy. Simultaneously the maximum plantar pressures and maximum plantar contact areas of both feet during the standing phase of walking were analyzed using a pressure distribution measuring system. The ratios of the measured values for the affected side to that of the unaffected side were calculated. The mean ratio of the maximum plantar pressure of the affected/unaffected limb on standing changed from 61.5%±12.4% to 75.0%±9.5% at one month, and 61.2%±7.3% at three months after BoNT-A therapy. The mean maximum plantar contact area ratios also changed from 75.3%±11.7% to 87.9%±8.7% at one month and 77.8%±8.8% at three months. For both parameters, the ratios were significantly increased at one month after BoNT-A, compared to the other time points(P<0.01). These results suggest that BoNT-A therapy reduces muscle spasticity of the lower limbs, which improves the range of motion of the ankle joints, leading to improved plantar contact during the standing phase of walking. This pressure measurement system may be useful for assessing the effectiveness of BoNT-A therapy.
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