Botox effective for HSP

Research study reports good results


Walking speed was improved and calf muscle tone reduced in a study of 15 HSPers who received Botox injections and did daily stretching exercises for the 18 weeks following. Muscle strength was preserved and balance was unaffected.


Objective: Although calf muscle spasticity is often treated with botulinum toxin type-A, the effects on balance and gait are ambiguous. Hereditary spastic paraplegia is characterized by progressive spasticity and relatively mild muscle weakness of the lower limbs. It is therefore a good model to evaluate the functional effects of botulinum toxin type-A.

Design: Explorative pre-post intervention study.

Subjects: Fifteen subjects with pure hereditary spastic paraplegia.

Methods: Patients with symptomatic calf muscle spasticity and preserved calf muscle strength received botulinum toxin type-A injections in each triceps surae (Dysport®, 500-750 MU) followed by daily stretching exercises (18 weeks). Before intervention (T0), and 4 (T1) and 18 (T2) weeks thereafter, gait, balance, motor selectivity, calf muscle tone and strength were tested.

Results: Mean comfortable gait velocity increased from T0 (0.90 m/s (standard deviation (SD) 0.18)) to T1 (0.98 m/s (SD 0.20)), which effect persisted at T2, whereas balance and other functional measures remained unchanged. Calf muscle tone declined from T0 (median 2; range 1-2) to T1 (median 0; range 0-1), which effect partially persisted at T2 (median 1; range 0-2). Calf muscle strength did not change

Conclusion: Botulinum toxin type-A treatment and subsequent muscle stretching of the calves improved comfortable gait velocity and reduced muscle tone in patients with hereditary spastic paraplegia, while preserving muscle strength. Balance remained unaffected.


SOURCE: J Rehabil Med. 2014 Oct 16. doi: 10.2340/16501977-1909. [Epub ahead of print] PMID: 25325386 [PubMed – as supplied by publisher]

Functional effects of botulinum toxin type-A treatment and subsequent stretching of spastic calf muscles: A study in patients with hereditary spastic paraplegia.

Niet MD1, Bot STvan de Warrenburg BPWeerdesteyn VGeurts AC.

1Department of Rehabilitation, Centre for Evidence Based Practice and Donders Institute for Brain, Cognition, and Behaviour, Radboud, Radboud University Medical Centre, The Netherlands.

Your email address will not be published. Required fields are marked *