TY - JOUR T1 - Botulinum toxin treatment for lower limb extensor spasticity in chronic hemiparetic patients. JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 1321 LP - 1324 DO - 10.1136/jnnp.57.11.1321 VL - 57 IS - 11 AU - S Hesse AU - D Lücke AU - M Malezic AU - C Bertelt AU - H Friedrich AU - M Gregoric AU - K H Mauritz Y1 - 1994/11/01 UR - http://jnnp.bmj.com/content/57/11/1321.abstract N2 - Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including the measurement of vertical ground reaction forces showed a statistically significant (p < 0.01) improvement in velocity, stride length, stance symmetry, and the length of the force point of action under the affected foot. Qualitative improvements on the force diagrams indicated a better loading, advancement of the body, and push off of the affected limb in seven patients. Eight weeks after the injection the effects waned. ER -