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Effects of Onabotulinum Toxin A on Gait in Parkinson’s Disease Patients with Foot Dystonia

Published online by Cambridge University Press:  09 March 2021

Pei Huang
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Yuan-Yuan Li
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Jung E. Park
Affiliation:
Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
Ping Huang
Affiliation:
Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases with Integrated Chinese-Western Medicine, Shanghai Institute of Traumatology and Orthopaedics, Department of Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China
Qin Xiao
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Ying Wang
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Sheng Chen
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Sheng-Di Chen
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Jun Liu
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Yi-Wen Wu
Affiliation:
Department of Neurology, Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
Corresponding

Abstract:

We investigated the effects of botulinum toxin on gait in Parkinson’s disease (PD) patients with foot dystonia. Six patients underwent onabotulinum toxin A injection and were assessed by Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS), visual analog scale (VAS) of pain, Timed Up and Go (TUG), Berg Balance Test (BBT), and 3D gait analysis at baseline, 1 month, and 3 months. BFMDRS (p = 0.002), VAS (p = 0.024), TUG (p = 0.028), and BBT (p = 0.034) were improved. Foot pressures at Toe 1 (p = 0.028) and Midfoot (p = 0.018) were reduced, indicating botulinum toxin’s effects in alleviating the dystonia severity and pain and improving foot pressures during walking in PD.

Résumé :

RÉSUMÉ :

Effets de la toxine botulique de type A sur la démarche de patients atteints de la maladie de Parkinson et aux prises avec des symptômes de dystonie du pied.

Nous nous sommes penchés sur les effets de la toxine botulique de type A (onabotulinum toxin A) sur la démarche de patients atteints de la maladie de Parkinson (MP) et aux prises avec des symptômes de dystonie du pied. Six patients ont donc bénéficié d’injections de toxine botulique de type A et ont été évalués ensuite à l’aide des outils suivants : l’échelle d’évaluation de la dystonie de Burke Fahn-Marsden (EEDBFM), l’échelle visuelle analogique (EVA) de la douleur, le test Timed Up and Go (TUG), l’échelle d’évaluation de l’équilibre de Berg (EEEB) ainsi que l’analyse en 3 dimensions de la démarche (au début de cette étude, au bout d’un mois et au bout de 3 mois). Les résultats obtenus à l’EEDBFM (p = 0,002), à l’EVA (p = 0,024) et aux tests TUG (p = 0,028) et EEEB (p = 0,034) ont ainsi montré une amélioration. À noter aussi que la pression exercée sur le gros orteil (toe 1) (p = 0,028) et le pied moyen (p = 0,018) a été réduite chez ces patients, ce qui indique que la toxine botulique de type A parvient à atténuer la gravité de la dystonie et la douleur mais aussi à améliorer la pression exercée sur les pieds au moment où ces patients parkinsoniens marchent.

Type
Brief Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Canadian Journal of Neurological Sciences Inc.

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Footnotes

*

Pei Huang and Yuan-Yuan Li contributed equally to this work.

References

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