Session Speaker

Functional Influence of Botulinum Neurotoxin Type A 150kDa Treatment (Xeomin®) of Multifocal Upper and Lower limb Spasticity on Chronic Hemiparetic Gait: a Case Report
Dott Falso Maurizio, Rosalba Galluso, Andrea Malvicini
Italy

Objective: To assess the modification of walking velocity and hemiplegic shoulder pain in a patient with functional disorders related to a chronic upper and lower left limb spasticity by multifocal botulinum neurotoxin Type A 150KDa treatment

Design: This can be considered a case interventional evaluation. Patient: Woman, 67 years old, with a chronic residual left hemiparesis with chronic hemiparetic gait attributable to right hemisphere stroke.

Methods: BoNTX-A (Xeomin®) was injected in the left pectoralis complex, left biceps, left flexor digitorum profundus, left lumbricales, left tibialis posterior and soleus. The main measures were: VGA (Visual Gait Analysis) scoring, gait velocity measurement (m/sec), TCT (Trunk Control Test), MI (Motricity Index) for the upper and lower limb, quantification of patient’s own grade of pain (VAS), and the modified Ashworth Scale.

Results: After treatment with botulinum neurotoxin A, we observed a significant change in all clinical parameters, including quality of gait and walking velocity. Patient showed a significant decrease of shoulder pain as like as of proximal spasticity of the upper limb and lower limb, as documented by the modified Ashworth Scale. Trunk postural attitude and paraxial muscle recruitment increased in maintaining sitting and vertical position, as documented by the Trunk Control Test. Arm voluntary function increased in testing normal daily activity tasks, as documented by Motricity Index.

We observed a significant improvement in initial foot contact during stance phase of gait, as documented by the visual gait analysis. These modifications were statistically significant for the most of all parameters considered (p < 0.05). No adverse effect was observed using this type of BoNTA.

Conclusions: This interventional case study suggests that a comprehensive clinical-observational investigation is simple to use and provide useful data in the evaluation of the functional influence of botulinum neurotoxin type A 150KDa treatment (Xeomin®) on chronic hemiparetic gait and hemiplegic shoulder pain.