Journal of rehabilitation medicine. Clinical communications最新文献

{"title":"RETROSPECTIVE ANALYSIS OF PATIENTS WITH IMMEDIATE DECANNULATION IN SEVERE ACQUIRED BRAIN INJURY (RAPID-SABI).","authors":"Robbert-Jan VAN Hooff, Mette Lindelof, Emma Ghaziani, Trine Hørmann Thomsen, Christina Kruuse, Christian Gunge Riberholt, Charlotte Rath","doi":"10.2340/jrm-cc.v8.42068","DOIUrl":"10.2340/jrm-cc.v8.42068","url":null,"abstract":"<p><strong>Objective: </strong>To examine an early decannulation protocol in adult severe acquired brain injury (SABI) patients.</p><p><strong>Design: </strong>Retrospective, observational cohort study.</p><p><strong>Subjects/patients: </strong>Tracheotomized SABI patients ≥ 18 years admitted to a neurorehabilitation unit.</p><p><strong>Methods: </strong>Primary outcome measure was difference in survival rate within first year of discharge. Secondary outcome measures were respiratory infections treated with antibiotics, rate of re-cannulation, time from admission to decannulation, length of stay, difference in rate of re-admission due to pneumonia within first year of discharge and difference in rate of tracheal tube dependency within first year of discharge.</p><p><strong>Results: </strong>No statistical significance in survival rate within the first 12 months from discharge was found. Median time from admission to decannulation was 32 days (interquartile range [IQR] 14-61) vs 9 days (IQR 0-13) in the control and intervention group, respectively (<i>p</i> < 0.0003). Median length of stay was 66 days (IQR 54-92) in the control group vs 60 (IQR 48-75) days in the intervention group (<i>p</i> = 0.168).</p><p><strong>Conclusion: </strong>A new early decannulation protocol omitting evaluation of tolerance to tracheostomy tube capping and fiberoptic endoscopic evaluation of swallowing was non-inferior to previous procedures in survival rate within first year of discharge. The early decannulation protocol allowed for significantly earlier decannulation.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"42068"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORRELATION BETWEEN TRAUMATIC BRAIN INJURY, OBESITY AND INSULIN-RESISTANCE - A CASE REPORT.","authors":"Laura De Wilde, Charlotte De Ruysscher, Kristine Oostra","doi":"10.2340/jrm-cc.v8.36827","DOIUrl":"10.2340/jrm-cc.v8.36827","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury is a significant global health concern. It often results from high-velocity accidents and leads to diffuse axonal injury, causing consciousness disorders and potentially permanent cognitive and behavioural changes. Individuals with traumatic brain injury often exhibit weight gain, potentially leading to obesity. This weight increase is influenced by cognitive dysfunction, reduced physical activity and metabolic changes.</p><p><strong>Case report: </strong>A 23-year-old woman suffered a traumatic brain injury after a traffic accident, with an initial Glasgow Coma Scale score of 5/15. Positive neurological improvement was observed during her stay in the intensive care unit and the neurosurgical department. Subsequently, she was transferred to the rehabilitation department, where she faced significant challenges, including mood fluctuations, cognitive impairments and substantial weight gain. Her body mass index (BMI) increased from 23 kg/m² pre-accident to a maximum of 36 kg/m², despite interventions like medications and lifestyle changes. Blood tests revealed insulin-resistance and metformin initiated a successful weight reduction.</p><p><strong>Conclusion: </strong>Managing weight gain following traumatic brain injury requires effective interventions that acknowledge its complexity and multifaceted nature, including lifestyle modifications, behavioural therapy and potentially pharmacotherapy or bariatric surgery. Further research is essential to better understand underlying mechanisms and evaluate intervention effectiveness in this specific patient population.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"36827"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EARLY SURGERY IN RARE KNEE HETEROTOPIC OSSIFICATION LEADS TO SUCCESSFUL FUNCTIONAL OUTCOME: A CASE REPORT.","authors":"Stijn Pierreux, Samar M Hatem, Stijn Roggeman, Marc Schiltz","doi":"10.2340/jrm-cc.v8.41323","DOIUrl":"10.2340/jrm-cc.v8.41323","url":null,"abstract":"<p><strong>Background: </strong>Heterotopic ossification is a common complication after joint replacement surgery, such as hip or knee arthroplasty. In the intensive care unit, it is most commonly associated with traumatic brain injury or spinal cord injury. To prevent recurrence, surgical resection of heterotopic ossification is recommended once the ectopic bone has fully matured, which is estimated to occur after at least 12 months.</p><p><strong>Case presentation: </strong>This case describes a young woman with no relevant previous medical history who developed severe bilateral heterotopic ossification on the anteromedial sides of her knees after an intensive care unit stay. Passive flexion of both knees was limited to 50°. X-ray was a simple diagnostic tool. Predisposing factors were extended immobilization, prolonged systematic inflammatory condition and mechanical ventilation. Due to the failure of initial conservative therapy, the heterotopic ossification was resected early, 4 months after onset of first symptoms. Following an intensive rehabilitation program, a normal, pain-free gait and full range of motion of both knees were achieved 9 months after surgery.</p><p><strong>Conclusion: </strong>This case report demonstrates that early resection of heterotopic ossification can result in a good clinical and functional outcome.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"41323"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECTIVENESS OF RADIAL EXTRACORPOREAL SHOCKWAVE THERAPY IN THE LOCAL MANAGEMENT OF HYPERTONIA (SPASTICITY AND DYSTONIA) IN PATIENTS WITH CEREBRAL PALSY.","authors":"Tamara Biedermann Villagra, Miriam Tur Segura, Francisca Gimeno Esteve, Jordi Jimenez Redondo, Nicolás García Rodríguez, Raimon Milà Villarroel","doi":"10.2340/jrm-cc.v7.41084","DOIUrl":"https://doi.org/10.2340/jrm-cc.v7.41084","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effect of radial extracorporeal shockwave therapy on the reduction of local hypertonia in patients with cerebral palsy.</p><p><strong>Design: </strong>Explorative pre-post intervention study.</p><p><strong>Subjects/patients: </strong>Forty-five patients with cerebral palsy.</p><p><strong>Methods: </strong>All patients received 3 sessions of radial extracorporeal shockwave therapy with a time interval of 1 week for each session. The outcomes were V1 and V3 of the Tardieu scale, the Timed Up and Go test, and the 10-metre walk test. The measurements were collected at baseline, immediately after the last session of shockwaves, at 12 and 24 weeks after baseline.</p><p><strong>Results: </strong>The statistical analysis used was a mixed linear model of repeated measures. The degrees on the Tardieu scale increased significantly in all the treated muscles. The results of the Timed Up and Go test and the 10 m walk test confirmed a significant functional effect after the shockwave therapy (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Functional improvement in patients treated with extracorporeal shockwave therapy has been observed to last up to 24 weeks.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"7 ","pages":"41084"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHARACTERIZATION OF BASELINE SYMPTOMS AND FUNCTIONAL IMPAIRMENTS IN A LARGE COHORT OF OUTPATIENTS ATTENDING A LONG COVID REHABILITATION CLINIC IN THE UNITED KINGDOM.","authors":"Matthew B Downer, Emma Tucker, Emily Fraser, Anton Pick","doi":"10.2340/jrm-cc.v7.39984","DOIUrl":"https://doi.org/10.2340/jrm-cc.v7.39984","url":null,"abstract":"<p><strong>Objective: </strong>In response to the high prevalence and morbidity associated with long COVID (LC), outpatient rehabilitation programmes were created across jurisdictions. We aimed to characterize baseline symptoms and impairments of patients attending outpatient LC rehabilitation.</p><p><strong>Design: </strong>This study was a retrospective quality-improvement analysis.</p><p><strong>Subjects/patients: </strong>Patients attending outpatient LC rehabilitation at the Oxfordshire Post-Covid Service.</p><p><strong>Methods: </strong>Data included age/sex and 6 questionnaires performed at baseline: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Dyspnoea-12 (D12), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Assessment-7 (GAD-7), Visual Analogue Scale (VAS) of self-rated health, and the Work And Social Adjustment Scale (WSAS). All scores were dichotomized (indicating presence/absence of clinically significant pathology). Potential differences between age (</≥ 50 years) and sex were assessed using χ² tests.</p><p><strong>Results: </strong>A total of 422 patients were included (mean/standard deviation [SD] age = 47.1/13.2;132/31.3% male). A total of 76% had significant fatigue (FACIT-F), 69% had breathlessness (D12), 55% had depression (PHQ-9), 34% had anxiety (GAD-7), 41% self-reported poor health (VAS), and 57% had work/social life dysfunction (WSAS). D12 scores differed between age groups (older > younger, χ² = 3.19/<i>p</i> = 0.048), with no differences observed on other scales.</p><p><strong>Conclusion: </strong>In this preliminary study, a high proportion of LC outpatients had significant impairments across domains. The findings of this study reaffirm the need for high-quality, multidisciplinary LC rehabilitation, and may be used to help build a standardized set of outcome measures moving forward.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"7 ","pages":"39984"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INPATIENT REHABILITATION AND FUNCTIONAL OUTCOME OF A CASE OF ANTI-SRP IMMUNE-MEDIATED NECROTIZING MYOPATHY.","authors":"Nicole Chen, Khin Yamin Thein, San San Tay","doi":"10.2340/jrm-cc.v7.40653","DOIUrl":"https://doi.org/10.2340/jrm-cc.v7.40653","url":null,"abstract":"<p><strong>Objective: </strong>Immune-mediated necrotizing myopathy associated with anti-signal recognition particle antibodies is a rare and debilitating condition characterized by significant muscle weakness and resultant disability. Although there are existing recommendations for physical therapy and exercise for patients with myositis in current literature, effective rehabilitation guidelines for such patients have not been fully established.</p><p><strong>Case report: </strong>A 42-year-old woman presented with subacute onset proximal upper and lower limb weakness and dysphagia. She was diagnosed with anti-SRP immune-mediated necrotizing myopathy and was promptly initiated on aggressive immunosuppressive therapy. Despite this, she had significant impairment in function, including the inability to ambulate.</p><p><strong>Intervention and outcome: </strong>The patient underwent an intensive structured inpatient rehabilitation programme consisting of strength and endurance exercises combined with functional exercises and robot-assisted gait training. This resulted in major improvements in objective outcomes including Functional Independence Measure, Modified Barthel Index, 10-metre-walk test and 6-minute-walk test scores. The programme was well tolerated by the patient with no adverse events.</p><p><strong>Conclusion: </strong>This case details the crucial role of a structured rehabilitation programme in the holistic management of a patient with anti-SRP immune-mediated necrotizing myopathy. It also highlights the use of robotics in gait training, resulting in successful functional outcomes for the patient.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"7 ","pages":"40653"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPLORING THE FEASIBILITY OF PLATELET-RICH PLASMA INJECTIONS FOR INTERVERTEBRAL DISCOPATHY: A PILOT STUDY.","authors":"Jean-François Kaux, Christophe Demoulin, Marie-Antoinette Ferrara, Robert Fontaine, Stéphanie Grosdent, Sarah Bethlen, Marco Tomasella, Philippe Gillet, Marc Vanderthommen","doi":"10.2340/jrm-cc.v7.18305","DOIUrl":"10.2340/jrm-cc.v7.18305","url":null,"abstract":"<p><strong>Objective: </strong>This longitudinal pilot study aimed to evaluate the feasibility, safety and potential benefits of Platelet-Rich Plasma injections into the lumbar intervertebral discs in patients with low back pain and degenerative intervertebral monodiscopathy, assessing potential efficacy on disability.</p><p><strong>Design: </strong>Longitudinal pilot study.</p><p><strong>Methods: </strong>Six participants with chronic low back pain and lumbar degenerative intervertebral disc (monodiscopathy) disease underwent 1 Platelet-Rich Plasma injection, with a 1-year follow-up. Platelet-Rich Plasma injections were administered into the lumbar intervertebral disc, and outcomes were measured using the Roland Morris Disability Questionnaire, numeric rating scale for pain, Tampa scale for kinesiophobia and lumbar flexion range. Magnetic resonance imaging analysis assessed disc changes.</p><p><strong>Results: </strong>No adverse events were reported. At the end of the 1-year follow-up, half of the patients showed significant improvements in disability scores at 1 year, while 3 of the 6 patients had no change. Magnetic resonance imaging revealed no significant disc changes.</p><p><strong>Conclusion: </strong>Platelet-Rich Plasma injections show promise for some patients with low back pain and degenerative intervertebral discopathy patients. However, caution is warranted due to study limitations, including small sample size and lack of a control group. Further research is needed to define Platelet-Rich Plasma therapy protocols.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"7 ","pages":"18305"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FOLLOW-UP OF PATIENTS WITH POST COVID-19 CONDITION AFTER A MULTIDISCIPLINARY TEAM ASSESSMENT: A PILOT STUDY.","authors":"Alexander Wigge, Johanna Philipson, Solveig Hällgren, Helena Filipsson, Britt-Marie Stålnacke","doi":"10.2340/jrm-cc.v7.24581","DOIUrl":"10.2340/jrm-cc.v7.24581","url":null,"abstract":"<p><strong>Objective: </strong>To follow up patients with post-COVID-19 condition (PCC) 6 months after a multidisciplinary team assessment in specialist care regarding symptoms of pain, anxiety, depression, fatigue and cognition, level of activity, physical activity and sick leave.</p><p><strong>Methods: </strong>A prospective pilot study conducted in a clinical setting of patients (<i>n</i> = 22) with PCC referred from primary healthcare to a specialist clinic for a 2 day-multidisciplinary team assessment followed by a subsequent rehabilitation plan. Data were collected through questionnaires filled in prior to the team assessment and 6 months later.</p><p><strong>Results: </strong>Fifteen of the initial 22 patients participated in the follow-up. No statistically significant improvements were seen in any of the questionnaires after 6 months. However, 76.9% of the participants perceived the intervention as being helpful. This differed between the genders, where all the women 100% (<i>n</i> = 8) perceived it as being helpful, compared with 40% (<i>n</i> = 2) of the men (<i>p</i> = 0.012).</p><p><strong>Conclusions: </strong>Based on these findings, the benefit of a multidisciplinary team assessment of PCC is not fully convincing. However, since the participants themselves perceived the intervention as being helpful, the team assessment seems to be of some value. Further studies with larger populations would be of interest.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"7 ","pages":"24581"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TIMELY MUNICIPALITY REHABILITATION AFTER HOSPITALISATION REDUCES READMISSION AND EARLY MORTALITY.","authors":"Søren Bie Bogh, Sören Möller, Mette Birk-Olsen, Lars Morsø","doi":"10.2340/jrm-cc.v7.40636","DOIUrl":"https://doi.org/10.2340/jrm-cc.v7.40636","url":null,"abstract":"<p><strong>Objective: </strong>Firstly, the study explores the association between timely initiation of rehabilitation and 90-day and 365-day all-cause acute readmission and secondly, 90-day and 365-day all-cause mortality in a cohort of Odense Municipality residents.</p><p><strong>Methods: </strong>The registry-based observational cohort study investigates acute contacts at Odense University Hospital from 2015 to 2020. Descriptive statistics, Cox regression and cumulative incidence rates were used for analysis.</p><p><strong>Subjects: </strong>The study utilizes initiated rehabilitation referrals within 60 days from Odense Municipality residents.</p><p><strong>Results: </strong>In total, 7,377 rehabilitation plans were initiated, including 5051 (68.5%) within the legal timeframe. Overall, timely initiation of rehabilitation within the legal timeframe was associated with a significantly reduced risk of 90-day all-cause acute readmission (Adjusted HR 0.82, 95% CI 0.74-0.90).In the adjusted analysis, timely initiation was also significantly associated with reduced risk in 365-day all-cause acute readmission (HR 0.90, 95% CI 0.83-0.97). Each week of delay in initiation of rehabilitation was associated with an increased risk of readmission (HR 1.05, 95% CI 1.02-1.07). Further, timely initiation of rehabilitation was associated with a significant reduction in the risk of 365-day all-cause mortality (HR 0.74, 95% CI 0.61-0.89).</p><p><strong>Conclusion: </strong>Timely initiation of rehabilitation within the legal timeframe of 7 or 14 days was associated with significantly reduced risk of 90-day and 365-day all-cause acute readmission. Timely initiation of rehabilitation was also associated with significant reduction in the risk of 365-day all-cause mortality.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"7 ","pages":"40636"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11388109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LONG-TERM REPEATED BOTULINUM TOXIN A TREATMENT OVER 12 YEARS GRADUALLY CHANGES GAIT CHARACTERISTICS: SINGLE-CASE STUDY.","authors":"Hiroki Tanikawa, Hitoshi Kagaya, Shota Itoh, Kento Katagiri, Hikaru Kondoh, Kenta Fujimura, Satoshi Hirano, Toshio Teranishi","doi":"10.2340/jrmcc.v7.40827","DOIUrl":"https://doi.org/10.2340/jrmcc.v7.40827","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the long-term efficacy of repeated botulinum toxin A injections into the same muscles for ameliorating lower limb spasticity and gait function.</p><p><strong>Design: </strong>Single-case study.</p><p><strong>Patient: </strong>A 36-year-old woman with right cerebral haemorrhage received her first botulinum toxin A injection 1,296 days after onset. The patient underwent 30 treatments over 12 years after the first injection to improve upper and lower limb spasticity and abnormal gait patterns. The mean duration between injections was 147 days.</p><p><strong>Methods: </strong>The Modified Ashworth Scale, passive range of motion, gait velocity, and degree of abnormal gait patterns during treadmill gait were evaluated pre-injection and at 2, 6, and 12 weeks after every injection.</p><p><strong>Results: </strong>The follow-up period showed no injection-related adverse events. Comfortable overground gait velocity gradually improved over 30 injections. The Modified Ashworth Scale and passive range of motion improved after each injection. Pre-injection values of the degree of pes varus, circumduction, hip hiking, and knee extensor thrust improved gradually. However, the degree of contralateral vaulting, excessive lateral shift of the trunk, and insufficient knee flexion did not improve after 30 injections.</p><p><strong>Conclusion: </strong>Repeated botulinum toxin A injections effectively improve abnormal gait patterns, even when a single injection cannot change these values.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"7 ","pages":"40827"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}