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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 2007 September;43(3):319-25

language: English

Repeated botulinum toxin injections can improve mobility in patients with spinal cord lesions

Catz A. 1,2, Barkol H. 2,3, Steinberg F. 3, Ronen J. 1,2, Bluvshtein V. 1,2, Keren O. 2,4

1 Spinal Department and Research Laboratory Loewenstein Rehabilitation Hospital, Raanana, Israel
2 Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
3 Physiotherapy Department Loewenstein Rehabilitation Hospital, Raanana, Israel
4 Neurophysiologic Unit Loewenstein Rehabilitation Hospital, Raanana, Israel


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Aim. The aim of this study was to increase the knowledge about the response to botulinum toxin (BTX) injections to spastic leg muscle motor points (MP) in spinal cord lesion (SCL) patients, and describe improvement of mobility with repeated BTX injections.
Methods. Six patients with ASIA grade C or D SCL were studied at the Loewenstein Rehabilitation Center, Israel. The main outcome measures were: modified Ashworth scale scores, range of motion (ROM), and mobility spinal cord independence measure (SCIM) scores. BTX was injected twice within a few weeks’ interval to the MP of spastic leg muscles. The outcome measures were monitored before each injection and 2 weeks or more after the second injection.
Results. Following the first BTX injection the tonus decreased, ROM increased in all 6 patients, and mo- bility functioning improved in 4 of them. Following the repeated injection the tonus further decrea- sed, ROM further improved in 5 of 6 patients, and mobility functions further improved in 4 of 6 patients.
Conclusion. BTX can improve mobility in patients with SCL. Repeated injections may enhance the effect despite the concern for resistance formation. Further research is needed to support the findings and determine the optimal BTX doses and intervals between injections.

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