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Combined Treatment Fkt-Botulinum Toxin Type A (Btx-A) in Patients with Strumpell-Lorrain Disease.
Curr Pharm Des. 2016; 22(6):758-63.CP

Abstract

The Hereditary Spastic Paraparesis (HSP) or Strumpell-Lorrain disease is a heterogeneous neurodegenerative disease of the spinal cord. It is genetically transmitted and characterized by a progressive muscle weakness, spasticity of the lower limbs and awkward gain. There is no specific pharmacological treatment. The pharmacological therapy decreases the muscle tone and prevents stiffening). Physiotherapy restrains the progression of muscle atrophy, delays contraction of the tendons and gives greater mobility to people affected by the disease. The aim of this study is to demonstrate the efficacy of the combined treatment Fkt and Btx-A in patients with HSP. Retrospective study was conducted recruiting ten patients with spasticity according to Asworth modified scale of at least 2 and with gait deficit. They received treatment for 5 years with incobotulinumtoxinA and physiokinesiotherapy for addressing spasticity in the lower limbs. We evaluated muscle tone with miometric measurement both at the first visit (T0), and at subsequent ones (T1 after 30 days, T2 after 3 months from the first infiltration, T3 after 4 months up to the date of the following infiltration, T4 after 5 months). Baropodometric examination has proven essential for the study of the distribution of loads in statics and dynamics. The data analysis regarding tone assessment through measurements with Myoton highlighted hypertonus reduction in all the three muscle groups examined at T1 and the maintenance of constant values up to 5 months after the first infiltration. It also showed an increase in the percentage of back foot loading in both feet up to T4 (new inoculation, p<0, 05%). Baropodometric examination in dynamics (in particular the speed of the step) showed a gradual increase in this parameter which reaches a peak at 5 months (p<0, 05%) and then declines again in conjunction with the next infiltration treatment. This study showed the benefit of combined treatment with Btx and Fkt. The use of a local muscle relaxant drug with a physical targeted exercise guarantees better mobility of the treated segments, reducing tendon retractions as much as possible, and guarantees an adequate postural alignment. Baropodometric examination highlights a more advantageous distribution load, quite essential for avoiding tendinitis due to overload. Our data observation in the 5 years study shows how the curve relative to the speed of step and the graphics related to the variations of muscle tone remain almost constant with detectable improvement.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableDepartment of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy, Piazza Giulio Cesare 11, Bari 70100, Italy. marisa.megna@uniba.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26648460

Citation

Riccardo, Marvulli, et al. "Combined Treatment Fkt-Botulinum Toxin Type a (Btx-A) in Patients With Strumpell-Lorrain Disease." Current Pharmaceutical Design, vol. 22, no. 6, 2016, pp. 758-63.
Riccardo M, Angela L, Angela D, et al. Combined Treatment Fkt-Botulinum Toxin Type A (Btx-A) in Patients with Strumpell-Lorrain Disease. Curr Pharm Des. 2016;22(6):758-63.
Riccardo, M., Angela, L., Angela, D., Vita, P., Giulio, L., Pietroq, F., Giancarlo, I., & Marisa, M. (2016). Combined Treatment Fkt-Botulinum Toxin Type A (Btx-A) in Patients with Strumpell-Lorrain Disease. Current Pharmaceutical Design, 22(6), 758-63.
Riccardo M, et al. Combined Treatment Fkt-Botulinum Toxin Type a (Btx-A) in Patients With Strumpell-Lorrain Disease. Curr Pharm Des. 2016;22(6):758-63. PubMed PMID: 26648460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined Treatment Fkt-Botulinum Toxin Type A (Btx-A) in Patients with Strumpell-Lorrain Disease. AU - Riccardo,Marvulli, AU - Angela,Lopopolo, AU - Angela,Dantone, AU - Vita,Palmisano, AU - Giulio,Lancioni, AU - Pietroq,Fiore, AU - Giancarlo,Ianieri, AU - Marisa,Megna, PY - 2015/09/28/received PY - 2015/12/03/accepted PY - 2015/12/10/entrez PY - 2015/12/10/pubmed PY - 2016/10/25/medline SP - 758 EP - 63 JF - Current pharmaceutical design JO - Curr. Pharm. Des. VL - 22 IS - 6 N2 - The Hereditary Spastic Paraparesis (HSP) or Strumpell-Lorrain disease is a heterogeneous neurodegenerative disease of the spinal cord. It is genetically transmitted and characterized by a progressive muscle weakness, spasticity of the lower limbs and awkward gain. There is no specific pharmacological treatment. The pharmacological therapy decreases the muscle tone and prevents stiffening). Physiotherapy restrains the progression of muscle atrophy, delays contraction of the tendons and gives greater mobility to people affected by the disease. The aim of this study is to demonstrate the efficacy of the combined treatment Fkt and Btx-A in patients with HSP. Retrospective study was conducted recruiting ten patients with spasticity according to Asworth modified scale of at least 2 and with gait deficit. They received treatment for 5 years with incobotulinumtoxinA and physiokinesiotherapy for addressing spasticity in the lower limbs. We evaluated muscle tone with miometric measurement both at the first visit (T0), and at subsequent ones (T1 after 30 days, T2 after 3 months from the first infiltration, T3 after 4 months up to the date of the following infiltration, T4 after 5 months). Baropodometric examination has proven essential for the study of the distribution of loads in statics and dynamics. The data analysis regarding tone assessment through measurements with Myoton highlighted hypertonus reduction in all the three muscle groups examined at T1 and the maintenance of constant values up to 5 months after the first infiltration. It also showed an increase in the percentage of back foot loading in both feet up to T4 (new inoculation, p<0, 05%). Baropodometric examination in dynamics (in particular the speed of the step) showed a gradual increase in this parameter which reaches a peak at 5 months (p<0, 05%) and then declines again in conjunction with the next infiltration treatment. This study showed the benefit of combined treatment with Btx and Fkt. The use of a local muscle relaxant drug with a physical targeted exercise guarantees better mobility of the treated segments, reducing tendon retractions as much as possible, and guarantees an adequate postural alignment. Baropodometric examination highlights a more advantageous distribution load, quite essential for avoiding tendinitis due to overload. Our data observation in the 5 years study shows how the curve relative to the speed of step and the graphics related to the variations of muscle tone remain almost constant with detectable improvement. SN - 1873-4286 UR - https://www.unboundmedicine.com/medline/citation/26648460/Combined_Treatment_Fkt_Botulinum_Toxin_Type_A__Btx_A__in_Patients_with_Strumpell_Lorrain_Disease_ L2 - http://www.eurekaselect.com/137557/article DB - PRIME DP - Unbound Medicine ER -