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Faculty of Medical Sciences

The effect of botulinum toxin type A in stroke patients with a stiff knee gait

Hofste, A. (Anke) (2015) The effect of botulinum toxin type A in stroke patients with a stiff knee gait. thesis, Human Movement Sciences.

Full text available on request.

Abstract

Introduction The most common knee problem in stroke patients is not enough knee flexion during the swing phase of their gait cycle (stiff knee gait, abbr. SKG). A cause that often contributes to SKG in stroke patients is over-activity in the m. rectus femoris (RF). A treatment in rehabilitation to reduce over-activity in RF is Botulinum toxin type A (BTX) injections. Therefore, the aim of this study is to investigate the effect of Botulinum toxin type A injections into the rectus femoris muscle on the peak knee flexion (PKF) during swing phase and on functional tests in stroke patients with a stiff knee gait. Method This study had a block randomized crossover trial, twenty stroke patients were involved. All the subjects had placebo - and BTX interventions. The measurements included the 6 Minutes Walking Test (6MWT), the Timed Up and Go test (TUG) and the 10 Meter Walking Test (10MWT). Gait analysis was done by 3D kinematics (VICON Oxford metrics UK), to measure the knee kinematics PKF and the knee range of motion (KROM). The walking velocity was calculated by the 10MWT. Results In three variables (KROM, 6MWT and walking velocity) significant treatment effects were found, which indicated that there was an improvement in walking performance due to BTX intervention into RF in the subjects in these variables. Conclusion The different results between subjects indicate that the effect of BTX into RF for stroke patients with SKG is individually dependent, which could be concluded by varying baseline characteristics between subjects on walking performance. Although the subjects are tested on RF over-activity, the different outcomes in effectiveness of BTX injections into RF in the stroke patients with SKG still remain. Therefore, it can be concluded that even SKG was mainly due to RF over-activity, SKG could have multiple causes in stroke patients. Keywords Stiff knee gait, botulinum toxin type A, rectus femoris, spasticity, stroke, randomized crossover design.

Item Type: Thesis (UNSPECIFIED)
Supervisor name: Otter, dr. A.R. den and Tenniglo, dr. M.J.B.
Faculty: Medical Sciences
Date Deposited: 12 Apr 2022 09:11
Last Modified: 12 Apr 2022 09:11
URI: https://umcg.studenttheses.ub.rug.nl/id/eprint/3090

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