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The Efficacy of Botulinum Toxin on Spasticity of Lower Extremity and Gait Performance in Patients with Stroke

肉毒桿菌對於中風病患下肢痙攣和步態表現之療效

摘要


中風後產生的痙攣(Spasticity)導致了行走能力受損,且進一步影響了日常活動的獨立性。痙攣和緩慢的行走速度(gait velocity)、不正常的步態(gait pattern)相關。注射肉毒桿菌(Botulinum toxin)為安全的治療方式,且被視為治療局部痙攣的第一選擇。此篇文獻回顧的目的為,探討肉毒桿菌治療對於中風病患下肢痙攣和步態表現方面的效果。我們搜尋了1994年到2010年的Pubmed、Cochrane Library、MEDLINE等電子資料庫。使用的關鍵字為:痙攣(Spasticity)、中風(Stroke)、步態(Gait)和肉毒桿菌(Botulinum toxin)。納入條件包括:接受肉毒桿菌治療的成年中風病患,且研究結果需要包含步速(gait velocity)、空間性(spatial)或時間性的步態參數。共有十五篇研究納入此篇回顧,回顧結果顯示:肉毒桿菌治療可有效的降低中風病患的下肢痙攣,且增加步速與改善部份步態相關參數。另外中風病患在接受肉毒桿菌治療後,瑞佛彌動作評估(Rivermead motor assessment)與功能性行走量表(Functional ambulation categories)的分數,也有改善的趨勢。

關鍵字

步態 中風 痙攣 肉毒桿菌

並列摘要


Spasticity after stroke could cause walking ability impairment and further impeded independent of activity of daily life. Slow gait velocity and abnormal gait pattern were related to spasticity post stroke. Botulinum toxin (BTX) injection is a safe treatment. It was the first choice for focal spasticity treatment. The objective of this systemic review was to investigate the effects of botulinum toxin treatment on spasticity of lower extremity and gait performance in people with stroke. We searched the electronic databases (Pubmed, Cochrane Library, and MEDLINE) from year 1994 to 2010. Those key words were used in searching: spasticity, stroke, gait, and botulinum toxin. Included studies were adult stroke subjects received botulinum toxin treatment and outcome of studies including gait velocity, spatial or temporal parameters. Fifteen articles were choosing for this review. Results showed that spasticity of lower extremity was effectively decreased, gait velocity and part of spatial and temporal parameters of gait were improved post BTX injection. A tendency of improvement also found in Rivermead motor assessment (RMA) and functional ambulation categories (FAC) score post injection in people with stroke.

並列關鍵字

Gait Stroke Spasticity Botulinum toxin

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