BACKGROUND Foot drop causes considerable disability.The ankle-dorsiflexion is either weak or lost completely.Additionally,the ankle eversion and toe extensions are also impaired.This results in a high steppage gait wh...BACKGROUND Foot drop causes considerable disability.The ankle-dorsiflexion is either weak or lost completely.Additionally,the ankle eversion and toe extensions are also impaired.This results in a high steppage gait while walking.Overall,the gait is awkward;there is greater energy consumption;increased proneness to sustain injury of the forefoot;and more frequent falling during walking.AIM To document the clinical and epidemiological profile of foot drop patients in our population and evaluate the outcome of tibialis posterior(TP)tendon transfer for restoring the lost dorsiflexion in foot drop.METHODS The study was carried out at the National Institute of Rehabilitation Medicine in Islamabad over a period of 7 years.It included patients of all sexes and ages who presented with foot drop and had no contraindications for the procedure of TP tendon transfer.Exclusion criteria were patients who had contraindications for the operation.For instance,paralyzed posterior leg compartment muscles,Achilles tendon contracture,stiff ankle or toes,unstable ankle joint,weak gastrocnemius and scarred skin spanning over the route of planned tendon transfer.Also,patients who had the foot drop as a result of disc prolapses or brain diseases were excluded.Convenience sampling technique was used.The circum-tibial route of TP tendon transfer was employed.RESULTS Out of 37 patients,26(70.27%)were males whereas 11(29.72%)were females.The mean age was 22.59±8.19 years.Among the underlying causes of foot drop,road traffic accidents constituted the most common cause,found among 20(54.05%)patients.The share of complications included wound infections in 3(8.10%)patients and hypertrophic scars in 2(5.40%)patients.At 1-year postoperative follow-up visits,the outcome was excellent in 8(21.62%),good in 20(54.05%)and moderate in 9(24.31%).CONCLUSION The majority of cases of foot drop resulted from road traffic accidents that directly involved the common peroneal nerve.TP tendon transfer through the circumtibial route was found to be an easily executed effective operation which restored good dorsiflexion of the ankle among the majority of patients.展开更多
BACKGROUND One of the causes of foot drop is compression of the common peroneal nerve caused by space-occupying lesions such as a synovial cyst or a ganglion cyst.Most previous reports have involved compressive common...BACKGROUND One of the causes of foot drop is compression of the common peroneal nerve caused by space-occupying lesions such as a synovial cyst or a ganglion cyst.Most previous reports have involved compressive common peroneal neuropathy by intraneural ganglion cysts and synovial cysts.Compression of the peroneal nerve by extraneural ganglion cysts is rare.We report a rare case of compressive common peroneal neuropathy by an extraneural ganglion cyst.CASE SUMMARY A 46-year-old man was hospitalized after he reported a right foot drop for 1 mo.Manual muscle testing revealed scores of 1/5 on dorsiflexion of the right ankle.Hypoesthesia and paresthesia on the right lateral leg and foot dorsum were noted.He was diagnosed with a popliteal cyst by using electrophysiologic study and popliteal ultrasound(US).To facilitate common peroneal nerve(CPN)decompression,2 cc of sticky gelatinous material was aspirated from the cyst under US guidance.Electrical stimulation and passive and assisted active ROM exercises of the right ankle and strengthening exercises for weak muscles using elastic band were prescribed based on the change of muscle power.A posterior leaf spring ankle-foot orthosis was prescribed to assist the weak dorsiflexion of the ankle.Follow-up US revealed that the cystic lesion was growing and magnetic resonance imaging demonstrated compression of the CPN by the cystic mass.The cyst was resected to prevent impending compression of the CPN.CONCLUSION Precise diagnosis and immediate treatment are important in cases of compressive common peroneal neuropathy caused by an extraneural cyst.展开更多
Objective:To explore the effects of functional electrical stimulation and functional mid frequency electrical stimulation on lower limb function and balance function in stroke patients.Methods:20 cases of stroke patie...Objective:To explore the effects of functional electrical stimulation and functional mid frequency electrical stimulation on lower limb function and balance function in stroke patients.Methods:20 cases of stroke patients with foot drop after admission were randomly divided into the observation group and the control group,10 cases in each group.On the basis of the two groups of patients,the observation group used the gait induced functional electrical stimulation to stimulate the peroneal nerve and the pretibial muscle in the observation group.The control group used the computer medium frequency functional electrical stimulation to stimulate the peroneal nerve and the anterior tibial muscle for 2 weeks.Before and after treatment,the lower extremity simple Fugl-Meyer scale(FMA),the Berg balance scale(BBS)and the improved Ashworth scale were evaluated respectively,and the comparative analysis was carried out in the group and between the groups.Results:After 2 weeks of treatment,the scores of FMA and BBS in the two groups were significantly higher than those before the treatment(P<0.05),and the scores of FMA and BBS in the observation group were higher than those in the control group(P<0.05),and the flexor muscle tension of the ankle plantar flexor muscle of the observed group was lower than that of the control group(P<0.05).Conclusions:Exercise therapy combined with gait induced functional electrical stimulation or computer intermediate frequency functional electrical stimulation can significantly improve lower limb function and balance function in patients with ptosis,and the therapeutic effect of functional electrical stimulation combined with gait is better.展开更多
Introduction:?Patients presented with old neglected common peroneal nerve injuries, failed 2ry repair, compression neuropathies not improved after decompression and closed injuries with no improvement on conservative ...Introduction:?Patients presented with old neglected common peroneal nerve injuries, failed 2ry repair, compression neuropathies not improved after decompression and closed injuries with no improvement on conservative measures which are still unsolved problems. Poor recovery of this nerve after repair or decompression gives great importance to tendon transfer in these situations. Material and Methods: This study was conducted in Neurosurgery Department of Mansoura University from 2015 to 2018 on twenty-six patients (16 males and 10 females). Their age ranged from 6 - 58 years. All of them presented with persistent foot drop at least for one year after injury with no signs of improvement clinically or in electrophysiological studies. All patients underwent tibialis posterior tendon transfer through the interosseous membrane to the tendons of the leg anterior compartment. All of them were put in a plaster cast for four weeks postoperative. A physiotherapeutic program was applied for all patients as preoperative preparation and postoperative rehabilitation. Results: Twenty-two patients showed satisfactory results, three patients fair improvement and one patient no improvement. Two patients had wound infection and there was no mortality in this study. Conclusion:?Tendon transfer is an effective valid solution to be considered in the management of foot drop in these patients.展开更多
As one of the clinical manifestations in patients with hemiplegia after stroke,most of the patients with foot drop suffer from gait disturbance and balance dysfunction, generally accompanied by strephenopodia. There a...As one of the clinical manifestations in patients with hemiplegia after stroke,most of the patients with foot drop suffer from gait disturbance and balance dysfunction, generally accompanied by strephenopodia. There are relatively few researches on the balance ability of patients with foot drop worldwide,while the balance ability will directly affect the walking ability for recovery,so the research is significant in the rehabilitation of foot drop. In the experiment,the Cordura material ankle-foot orthosis （AFO）,one of the world leading technology products,is chosen as the experimental equipment because of its well-known durability and strength. The experiment studied the balance performance of patients with foot drop before and after wearing Cordura material AFO. The Berg scale was evaluated to discuss the effect of the orthosis on balance ability in patients with foot drop. It has been found that the wearing equipment BBS scores were significantly improved. There were significant differences comparing with the control group（ P＆lt;0.05）.But in the course of treatment the Berg balance scale （BBS） scores reduced individually,mainly in terms of leg flexibility.展开更多
Objective To evaluate the clinical efficacy of ultrasound-guided acupuncture at myofascial trigger points(MTrPs)on treating post-stroke foot drop.Methods Sixty patients with post-stroke foot drop were randomly assigne...Objective To evaluate the clinical efficacy of ultrasound-guided acupuncture at myofascial trigger points(MTrPs)on treating post-stroke foot drop.Methods Sixty patients with post-stroke foot drop were randomly assigned to an observation group 1(20 cases,1 case dropped out),an observation group 2(20 cases,2 casses dropped out),and a control group(20 cases).The control group received conventional acupuncture at Yanglingquan(GB34),Jiexi(ST41),Taichong(LR3),Zusanli(ST36),Xuanzhong(GB39),and Qiuxu(GB40)on the affected side,once daily.In addition to the treatment of the control group,the observation group 1 received acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day,while the observation group 2 received ultrasound-guided acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day.All groups were treated for twooweeks.Three-dimensional gaitanalysis was performed using an infrared motion capture system,and the Holden walking scale was used to evaluate walking ability before and after treatment in the three groups.Results Compared before treatment,the patients in the observation groups 1 and 2 showed increased walking speed(P<0.05,P<0.01),and improved Holden walking scale grades(P<0.05,P<0.01)after treatment;the patients in the observation group 2 also showed increased ankle dorsiflexion angles(P<0.05).The walking speeds of the observation groups 1 and 2 were faster than those of the control group after treatment(P<0.05),the Holden walking scale grade in the observation group 2 was superior to that in the control group(P<0.05).Conclusion The ultrasound-guided acupuncture at MTrPs could effectively improve gait function in post-stroke foot drop patients.展开更多
Foot drop(FD)secondary to lumbar degenerative disease is a relatively uncommon finding in spinal practice.Although only a part of patients with FD can obtain satisfactory recovery of their muscle strength after operat...Foot drop(FD)secondary to lumbar degenerative disease is a relatively uncommon finding in spinal practice.Although only a part of patients with FD can obtain satisfactory recovery of their muscle strength after operation,most of the articles still advocate surgical intervention at early stage.Despite the double roots compression is one of the accepted causes for FD,we describe an extremely rare case of a middle-age man presenting with a severe foot drop(tibialis anterior=0/5)resulted from three roots compression(L4-S1),who had undergone pedicle screws fixation(L3-S1),transforaminal lumbar interbody fusion(TLIF)at L4/5,laminotomy and discectomy at L5/S1 with laminotomy at L3/4 as well as conventional rehabilitation training postoperatively,which included strength training of the active and antagonistic muscles in the week lower extremity.Twelve months after surgery,the patient recovered from his deficit(tibialis anterior improved from 0/5 to 4/5).Therefore,we discuss the possible pathological mechanism and surgical option for the foot drop due to the lumbar degenerative disease as well as the potential risk factors portending prognosis postoperatively.展开更多
Currently, the population percentage of diabetics suffering Diabetic Peripheral Neuropathy (DPN) and foot-drop gait anomaly was estimates as 15% in the United States. The onset of foot-drop could not be detected until...Currently, the population percentage of diabetics suffering Diabetic Peripheral Neuropathy (DPN) and foot-drop gait anomaly was estimates as 15% in the United States. The onset of foot-drop could not be detected until symptoms could be observed visually, patient falling or patient experiencing painful gait issues and expensive medical tests. This research showed that by utilizing the plantar-pressure characteristics of DPN drop-foot gait, a set of index could be developed for the severity of DPN.展开更多
Objective: The aim of this study was to improve the Chinese Daoyin technique (physical and breathing exercises), which is an ancient rehabilitation method, to elevate its effect and to standardize its operational proc...Objective: The aim of this study was to improve the Chinese Daoyin technique (physical and breathing exercises), which is an ancient rehabilitation method, to elevate its effect and to standardize its operational procedure. Methods: Based on the ancient Chinese Daoyin technique, a six-step method was developed including: 1) motion imagination and imitation;2) mental and breathing regulation;3) target point determination;4) motion percussion;5) motion persistence;6) relaxation. Sixty drop-foot patients who suffered from hemiparesis after a stroke were randomly divided into the experimental group and the control group. Functional evaluation including Fugl-Meyer assessment score, Lovett manual muscle test (MMT), active range of motion of the ankle joint and electromyography were performed before and after the training course. The data were analyzed using the statistical software SPSS 12.0. Results: The differences between the two groups were significant. The effectiveness of the six-step group was significantly better than the effectiveness of the control group. Conclusion: The six-step method of the Chinese Daoyin technique is an effective rehabilitation training method for drop-foot in stroke patients with hemiparesis.展开更多
No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A （BTXA） injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial,...No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A （BTXA） injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial, we explored the safety and efficacy of two concentrations and two doses of BTXA in the treatment of spastic toot after stroke to optimize this treatment in these patients. Eligible patients （n = 104） were randomized into four groups. The triceps surae and tibialis posterior on the affected side were injected with BTXA at one of two doses （200 U or 400 U） and two concentrations （50 U/mL or 100 U/mL）. 2he following assessments were conducted before as well as 4 days and 1, 2, 4, and 12 weeks after treatment： spasticity, assessed using the modified Ashworth scale; basic functional mobility, assessed using a timed up and go test; pace, assessed using a 10-meter timed walking test; and the ability to walk, assessed using Holden＇s graded scale and a visual analog scale. The reported results are based on the 89 patients that completed the study. We found significant differences for the two doses and concentrations of BTXA to improve the ability of patients to walk independently, with the high-dose/low-concentration combination providing the best effect. Onset and duration of the ameliorating effects of BTXA were 4-7 days and 12 weeks, respectively. Thus, BTXA effectively treated foot spasms after stroke at an optimal dose of 400 U and concentration of 50 U/mL.展开更多
文摘BACKGROUND Foot drop causes considerable disability.The ankle-dorsiflexion is either weak or lost completely.Additionally,the ankle eversion and toe extensions are also impaired.This results in a high steppage gait while walking.Overall,the gait is awkward;there is greater energy consumption;increased proneness to sustain injury of the forefoot;and more frequent falling during walking.AIM To document the clinical and epidemiological profile of foot drop patients in our population and evaluate the outcome of tibialis posterior(TP)tendon transfer for restoring the lost dorsiflexion in foot drop.METHODS The study was carried out at the National Institute of Rehabilitation Medicine in Islamabad over a period of 7 years.It included patients of all sexes and ages who presented with foot drop and had no contraindications for the procedure of TP tendon transfer.Exclusion criteria were patients who had contraindications for the operation.For instance,paralyzed posterior leg compartment muscles,Achilles tendon contracture,stiff ankle or toes,unstable ankle joint,weak gastrocnemius and scarred skin spanning over the route of planned tendon transfer.Also,patients who had the foot drop as a result of disc prolapses or brain diseases were excluded.Convenience sampling technique was used.The circum-tibial route of TP tendon transfer was employed.RESULTS Out of 37 patients,26(70.27%)were males whereas 11(29.72%)were females.The mean age was 22.59±8.19 years.Among the underlying causes of foot drop,road traffic accidents constituted the most common cause,found among 20(54.05%)patients.The share of complications included wound infections in 3(8.10%)patients and hypertrophic scars in 2(5.40%)patients.At 1-year postoperative follow-up visits,the outcome was excellent in 8(21.62%),good in 20(54.05%)and moderate in 9(24.31%).CONCLUSION The majority of cases of foot drop resulted from road traffic accidents that directly involved the common peroneal nerve.TP tendon transfer through the circumtibial route was found to be an easily executed effective operation which restored good dorsiflexion of the ankle among the majority of patients.
文摘BACKGROUND One of the causes of foot drop is compression of the common peroneal nerve caused by space-occupying lesions such as a synovial cyst or a ganglion cyst.Most previous reports have involved compressive common peroneal neuropathy by intraneural ganglion cysts and synovial cysts.Compression of the peroneal nerve by extraneural ganglion cysts is rare.We report a rare case of compressive common peroneal neuropathy by an extraneural ganglion cyst.CASE SUMMARY A 46-year-old man was hospitalized after he reported a right foot drop for 1 mo.Manual muscle testing revealed scores of 1/5 on dorsiflexion of the right ankle.Hypoesthesia and paresthesia on the right lateral leg and foot dorsum were noted.He was diagnosed with a popliteal cyst by using electrophysiologic study and popliteal ultrasound(US).To facilitate common peroneal nerve(CPN)decompression,2 cc of sticky gelatinous material was aspirated from the cyst under US guidance.Electrical stimulation and passive and assisted active ROM exercises of the right ankle and strengthening exercises for weak muscles using elastic band were prescribed based on the change of muscle power.A posterior leaf spring ankle-foot orthosis was prescribed to assist the weak dorsiflexion of the ankle.Follow-up US revealed that the cystic lesion was growing and magnetic resonance imaging demonstrated compression of the CPN by the cystic mass.The cyst was resected to prevent impending compression of the CPN.CONCLUSION Precise diagnosis and immediate treatment are important in cases of compressive common peroneal neuropathy caused by an extraneural cyst.
文摘Objective:To explore the effects of functional electrical stimulation and functional mid frequency electrical stimulation on lower limb function and balance function in stroke patients.Methods:20 cases of stroke patients with foot drop after admission were randomly divided into the observation group and the control group,10 cases in each group.On the basis of the two groups of patients,the observation group used the gait induced functional electrical stimulation to stimulate the peroneal nerve and the pretibial muscle in the observation group.The control group used the computer medium frequency functional electrical stimulation to stimulate the peroneal nerve and the anterior tibial muscle for 2 weeks.Before and after treatment,the lower extremity simple Fugl-Meyer scale(FMA),the Berg balance scale(BBS)and the improved Ashworth scale were evaluated respectively,and the comparative analysis was carried out in the group and between the groups.Results:After 2 weeks of treatment,the scores of FMA and BBS in the two groups were significantly higher than those before the treatment(P<0.05),and the scores of FMA and BBS in the observation group were higher than those in the control group(P<0.05),and the flexor muscle tension of the ankle plantar flexor muscle of the observed group was lower than that of the control group(P<0.05).Conclusions:Exercise therapy combined with gait induced functional electrical stimulation or computer intermediate frequency functional electrical stimulation can significantly improve lower limb function and balance function in patients with ptosis,and the therapeutic effect of functional electrical stimulation combined with gait is better.
文摘Introduction:?Patients presented with old neglected common peroneal nerve injuries, failed 2ry repair, compression neuropathies not improved after decompression and closed injuries with no improvement on conservative measures which are still unsolved problems. Poor recovery of this nerve after repair or decompression gives great importance to tendon transfer in these situations. Material and Methods: This study was conducted in Neurosurgery Department of Mansoura University from 2015 to 2018 on twenty-six patients (16 males and 10 females). Their age ranged from 6 - 58 years. All of them presented with persistent foot drop at least for one year after injury with no signs of improvement clinically or in electrophysiological studies. All patients underwent tibialis posterior tendon transfer through the interosseous membrane to the tendons of the leg anterior compartment. All of them were put in a plaster cast for four weeks postoperative. A physiotherapeutic program was applied for all patients as preoperative preparation and postoperative rehabilitation. Results: Twenty-two patients showed satisfactory results, three patients fair improvement and one patient no improvement. Two patients had wound infection and there was no mortality in this study. Conclusion:?Tendon transfer is an effective valid solution to be considered in the management of foot drop in these patients.
基金the Fundamental Research Funds for the Central Universities,China(No.16D110301)Research Innovation Project of Shanghai Municipal Education Commission,China(No.201506000008)Science and Technology Guidance Project of Chinese Textile Industry Association(No.2015109)
文摘As one of the clinical manifestations in patients with hemiplegia after stroke,most of the patients with foot drop suffer from gait disturbance and balance dysfunction, generally accompanied by strephenopodia. There are relatively few researches on the balance ability of patients with foot drop worldwide,while the balance ability will directly affect the walking ability for recovery,so the research is significant in the rehabilitation of foot drop. In the experiment,the Cordura material ankle-foot orthosis （AFO）,one of the world leading technology products,is chosen as the experimental equipment because of its well-known durability and strength. The experiment studied the balance performance of patients with foot drop before and after wearing Cordura material AFO. The Berg scale was evaluated to discuss the effect of the orthosis on balance ability in patients with foot drop. It has been found that the wearing equipment BBS scores were significantly improved. There were significant differences comparing with the control group（ P＆lt;0.05）.But in the course of treatment the Berg balance scale （BBS） scores reduced individually,mainly in terms of leg flexibility.
文摘Objective To evaluate the clinical efficacy of ultrasound-guided acupuncture at myofascial trigger points(MTrPs)on treating post-stroke foot drop.Methods Sixty patients with post-stroke foot drop were randomly assigned to an observation group 1(20 cases,1 case dropped out),an observation group 2(20 cases,2 casses dropped out),and a control group(20 cases).The control group received conventional acupuncture at Yanglingquan(GB34),Jiexi(ST41),Taichong(LR3),Zusanli(ST36),Xuanzhong(GB39),and Qiuxu(GB40)on the affected side,once daily.In addition to the treatment of the control group,the observation group 1 received acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day,while the observation group 2 received ultrasound-guided acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day.All groups were treated for twooweeks.Three-dimensional gaitanalysis was performed using an infrared motion capture system,and the Holden walking scale was used to evaluate walking ability before and after treatment in the three groups.Results Compared before treatment,the patients in the observation groups 1 and 2 showed increased walking speed(P<0.05,P<0.01),and improved Holden walking scale grades(P<0.05,P<0.01)after treatment;the patients in the observation group 2 also showed increased ankle dorsiflexion angles(P<0.05).The walking speeds of the observation groups 1 and 2 were faster than those of the control group after treatment(P<0.05),the Holden walking scale grade in the observation group 2 was superior to that in the control group(P<0.05).Conclusion The ultrasound-guided acupuncture at MTrPs could effectively improve gait function in post-stroke foot drop patients.
基金the Beijing Health Technologies Promotion Program[number BHTPP202001]Beijing Municipal Natural Science Foundation[number 7222304]Beijing JST Research Horizontal Subject[number 2-3-1-1-164-02].
文摘Foot drop(FD)secondary to lumbar degenerative disease is a relatively uncommon finding in spinal practice.Although only a part of patients with FD can obtain satisfactory recovery of their muscle strength after operation,most of the articles still advocate surgical intervention at early stage.Despite the double roots compression is one of the accepted causes for FD,we describe an extremely rare case of a middle-age man presenting with a severe foot drop(tibialis anterior=0/5)resulted from three roots compression(L4-S1),who had undergone pedicle screws fixation(L3-S1),transforaminal lumbar interbody fusion(TLIF)at L4/5,laminotomy and discectomy at L5/S1 with laminotomy at L3/4 as well as conventional rehabilitation training postoperatively,which included strength training of the active and antagonistic muscles in the week lower extremity.Twelve months after surgery,the patient recovered from his deficit(tibialis anterior improved from 0/5 to 4/5).Therefore,we discuss the possible pathological mechanism and surgical option for the foot drop due to the lumbar degenerative disease as well as the potential risk factors portending prognosis postoperatively.
文摘Currently, the population percentage of diabetics suffering Diabetic Peripheral Neuropathy (DPN) and foot-drop gait anomaly was estimates as 15% in the United States. The onset of foot-drop could not be detected until symptoms could be observed visually, patient falling or patient experiencing painful gait issues and expensive medical tests. This research showed that by utilizing the plantar-pressure characteristics of DPN drop-foot gait, a set of index could be developed for the severity of DPN.
文摘Objective: The aim of this study was to improve the Chinese Daoyin technique (physical and breathing exercises), which is an ancient rehabilitation method, to elevate its effect and to standardize its operational procedure. Methods: Based on the ancient Chinese Daoyin technique, a six-step method was developed including: 1) motion imagination and imitation;2) mental and breathing regulation;3) target point determination;4) motion percussion;5) motion persistence;6) relaxation. Sixty drop-foot patients who suffered from hemiparesis after a stroke were randomly divided into the experimental group and the control group. Functional evaluation including Fugl-Meyer assessment score, Lovett manual muscle test (MMT), active range of motion of the ankle joint and electromyography were performed before and after the training course. The data were analyzed using the statistical software SPSS 12.0. Results: The differences between the two groups were significant. The effectiveness of the six-step group was significantly better than the effectiveness of the control group. Conclusion: The six-step method of the Chinese Daoyin technique is an effective rehabilitation training method for drop-foot in stroke patients with hemiparesis.
基金supported by a grant from the Shandong Science and Technology Development Plan Project in China,No.2012YD18031
文摘No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A （BTXA） injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial, we explored the safety and efficacy of two concentrations and two doses of BTXA in the treatment of spastic toot after stroke to optimize this treatment in these patients. Eligible patients （n = 104） were randomized into four groups. The triceps surae and tibialis posterior on the affected side were injected with BTXA at one of two doses （200 U or 400 U） and two concentrations （50 U/mL or 100 U/mL）. 2he following assessments were conducted before as well as 4 days and 1, 2, 4, and 12 weeks after treatment： spasticity, assessed using the modified Ashworth scale; basic functional mobility, assessed using a timed up and go test; pace, assessed using a 10-meter timed walking test; and the ability to walk, assessed using Holden＇s graded scale and a visual analog scale. The reported results are based on the 89 patients that completed the study. We found significant differences for the two doses and concentrations of BTXA to improve the ability of patients to walk independently, with the high-dose/low-concentration combination providing the best effect. Onset and duration of the ameliorating effects of BTXA were 4-7 days and 12 weeks, respectively. Thus, BTXA effectively treated foot spasms after stroke at an optimal dose of 400 U and concentration of 50 U/mL.
