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From these discussion,, key points in a walking reconstruction strategy through the combined use of BoNT-A and rehabilitation include: (1) injection techniques based on the identification of appropriate muscles through proper evaluation; (2) combined with rehabilitation; (3) effective spasticity control; (4) improvement in ankle joint range of motion; (5) promotion of a forward gait pattern; (6) adjustment of orthotics; and (7) maintenance of the effects through frequent BoNT-A administration. Based on these key points, the degree of muscle fibrosis and preintervention walking speed may serve as indicators for treatment strategies. With the accumulation of recent studies, a study focusing on walking functions is needed. As a result, it is suggested that BoNT-A treatment for lower limb spasticity should be established not just as a treatment for spasticity but also as a therapeutic strategy in the field of neurorehabilitation aimed at improving walking function.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11281298/pdf/","citationCount":"0","resultStr":"{\"title\":\"Gait Reconstruction Strategy Using Botulinum Toxin Therapy Combined with Rehabilitation.\",\"authors\":\"Takatoshi Hara, Toru Takekawa, Masahiro Abo\",\"doi\":\"10.3390/toxins16070323\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Numerous studies have established a robust body of evidence for botulinum toxin A (BoNT-A) therapy as a treatment for upper motor neuron syndrome. 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引用次数: 0
摘要
大量研究为 A 型肉毒毒素(BoNT-A)疗法治疗上运动神经元综合征提供了有力的证据。这些研究表明,肉毒杆菌毒素 A 疗法可改善痉挛、关节活动范围和减轻疼痛。然而,很少有研究将改善瘫痪或增强功能作为主要结果。本文讨论了痉挛评估、用药和康复的多个方面,目的是优化 BoNT-A 对下肢痉挛的影响,实现功能改善和步态重建。本文摘录了有关 BoNT-A 和下肢康复的研究,并提供了从中获得的新知识。通过这些讨论,BoNT-A 与康复相结合的步行重建策略的要点包括(1)通过正确评估确定合适肌肉的注射技术;(2)与康复训练相结合;(3)有效控制痉挛;(4)改善踝关节活动范围;(5)促进前倾步态;(6)调整矫形器;(7)通过频繁注射 BoNT-A 维持效果。根据这些要点,肌肉纤维化程度和干预前步行速度可作为治疗策略的指标。随着近期研究的不断积累,需要开展一项以步行功能为重点的研究。因此,有人建议,BoNT-A 治疗下肢痉挛不仅应作为痉挛的治疗方法,还应作为神经康复领域的一种治疗策略,旨在改善步行功能。
Gait Reconstruction Strategy Using Botulinum Toxin Therapy Combined with Rehabilitation.
Numerous studies have established a robust body of evidence for botulinum toxin A (BoNT-A) therapy as a treatment for upper motor neuron syndrome. These studies demonstrated improvements in spasticity, range of joint motion, and pain reduction. However, there are few studies that have focused on improvement of paralysis or functional enhancement as the primary outcome. This paper discusses the multifaceted aspects of spasticity assessment, administration, and rehabilitation with the goal of optimising the effects of BoNT-A on lower-limb spasticity and achieving functional improvement and gait reconstruction. This paper extracts studies on BoNT-A and rehabilitation for the lower limbs and provides new knowledge obtained from them. From these discussion,, key points in a walking reconstruction strategy through the combined use of BoNT-A and rehabilitation include: (1) injection techniques based on the identification of appropriate muscles through proper evaluation; (2) combined with rehabilitation; (3) effective spasticity control; (4) improvement in ankle joint range of motion; (5) promotion of a forward gait pattern; (6) adjustment of orthotics; and (7) maintenance of the effects through frequent BoNT-A administration. Based on these key points, the degree of muscle fibrosis and preintervention walking speed may serve as indicators for treatment strategies. With the accumulation of recent studies, a study focusing on walking functions is needed. As a result, it is suggested that BoNT-A treatment for lower limb spasticity should be established not just as a treatment for spasticity but also as a therapeutic strategy in the field of neurorehabilitation aimed at improving walking function.
期刊介绍:
Toxins (ISSN 2072-6651) is an international, peer-reviewed open access journal which provides an advanced forum for studies related to toxins and toxinology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.