Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study

<b>Objective:</b> Botulinum neurotoxin type A (BoNT/A) injections and the new vibration ergometry training (VET) are studied for their combined effect on improving functional mobility in patients with asymmetric lower limb spasticity. <b>Method:</b> Gait was analyzed using th...

Full description

Saved in:
Bibliographic Details
Main Authors: Harald Hefter, Dietmar Rosenthal, Sara Samadzadeh
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Journal of Functional Morphology and Kinesiology
Subjects:
Online Access:https://www.mdpi.com/2411-5142/10/1/41
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849341369782370304
author Harald Hefter
Dietmar Rosenthal
Sara Samadzadeh
author_facet Harald Hefter
Dietmar Rosenthal
Sara Samadzadeh
author_sort Harald Hefter
collection DOAJ
description <b>Objective:</b> Botulinum neurotoxin type A (BoNT/A) injections and the new vibration ergometry training (VET) are studied for their combined effect on improving functional mobility in patients with asymmetric lower limb spasticity. <b>Method:</b> Gait was analyzed using the Infotronic<sup>®</sup> system, which measures ground reaction forces and foot contact patterns by means of special force-sensitive shoes strapped over feet or street shoes. Gait was measured several times, depending on the protocol patients underwent. Seven patients with asymmetric lower limb spasticity were analyzed according to the control protocol (CG-group): after a baseline walk of 20 m (NV-W1) patients received their routine BoNT/A injection and had to walk the same distance a second time (NV-W2). Approximately 3–5 weeks later, they had to walk a third time (NV-W3). A further seven patients (VG-group) were analyzed according to the vibration protocol: after a baseline walk (V-W1), patients underwent a first vibration training (VET1), walked a second time (V-W2), received their routine BoNT/A injection, and walked a third time (V-W3). About four weeks later, they had to walk again (V-W4), received another vibration training (VET3), and walked a fifth time (V-W5). At least six months after the analysis according to the vibration protocol, these patients were also analyzed according to the control protocol. Eleven gait parameters were compared between the CG- and VG-group, and within the VG-group. <b>Result:</b> Patients in the VG-group experienced a significant improvement in gait four weeks after BoNT/A injection, unlike the patients in the CG-group. VG-patients also showed improved gait after two VET sessions. However, there was no further functional improvement of gait when BoNT/A injections and VET sessions were combined. <b>Conclusions:</b> BoNT/A injections enhance functional mobility in patients with mild asymmetric leg spasticity. VET also induces an immediate gait improvement and offers a further treatment approach for leg spasticity. Whether combining BoNT treatment and vibration training offers superior outcomes compared to either treatment alone requires further investigation.
format Article
id doaj-art-80bef9ef47f14b579dc496abc74c5b53
institution Kabale University
issn 2411-5142
language English
publishDate 2025-01-01
publisher MDPI AG
record_format Article
series Journal of Functional Morphology and Kinesiology
spelling doaj-art-80bef9ef47f14b579dc496abc74c5b532025-08-20T03:43:39ZengMDPI AGJournal of Functional Morphology and Kinesiology2411-51422025-01-011014110.3390/jfmk10010041Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot StudyHarald Hefter0Dietmar Rosenthal1Sara Samadzadeh2Department of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, GermanyDepartment of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, GermanyDepartment of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany<b>Objective:</b> Botulinum neurotoxin type A (BoNT/A) injections and the new vibration ergometry training (VET) are studied for their combined effect on improving functional mobility in patients with asymmetric lower limb spasticity. <b>Method:</b> Gait was analyzed using the Infotronic<sup>®</sup> system, which measures ground reaction forces and foot contact patterns by means of special force-sensitive shoes strapped over feet or street shoes. Gait was measured several times, depending on the protocol patients underwent. Seven patients with asymmetric lower limb spasticity were analyzed according to the control protocol (CG-group): after a baseline walk of 20 m (NV-W1) patients received their routine BoNT/A injection and had to walk the same distance a second time (NV-W2). Approximately 3–5 weeks later, they had to walk a third time (NV-W3). A further seven patients (VG-group) were analyzed according to the vibration protocol: after a baseline walk (V-W1), patients underwent a first vibration training (VET1), walked a second time (V-W2), received their routine BoNT/A injection, and walked a third time (V-W3). About four weeks later, they had to walk again (V-W4), received another vibration training (VET3), and walked a fifth time (V-W5). At least six months after the analysis according to the vibration protocol, these patients were also analyzed according to the control protocol. Eleven gait parameters were compared between the CG- and VG-group, and within the VG-group. <b>Result:</b> Patients in the VG-group experienced a significant improvement in gait four weeks after BoNT/A injection, unlike the patients in the CG-group. VG-patients also showed improved gait after two VET sessions. However, there was no further functional improvement of gait when BoNT/A injections and VET sessions were combined. <b>Conclusions:</b> BoNT/A injections enhance functional mobility in patients with mild asymmetric leg spasticity. VET also induces an immediate gait improvement and offers a further treatment approach for leg spasticity. Whether combining BoNT treatment and vibration training offers superior outcomes compared to either treatment alone requires further investigation.https://www.mdpi.com/2411-5142/10/1/41vibration ergometrybotulinum neurotoxin type Abotulinum toxin therapylower limb spasticityfunctional improvement of gaitmuscle spindle activity
spellingShingle Harald Hefter
Dietmar Rosenthal
Sara Samadzadeh
Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study
Journal of Functional Morphology and Kinesiology
vibration ergometry
botulinum neurotoxin type A
botulinum toxin therapy
lower limb spasticity
functional improvement of gait
muscle spindle activity
title Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study
title_full Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study
title_fullStr Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study
title_full_unstemmed Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study
title_short Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study
title_sort effects of combined vibration ergometry and botulinum toxin on gait improvement in asymmetric lower limb spasticity a pilot study
topic vibration ergometry
botulinum neurotoxin type A
botulinum toxin therapy
lower limb spasticity
functional improvement of gait
muscle spindle activity
url https://www.mdpi.com/2411-5142/10/1/41
work_keys_str_mv AT haraldhefter effectsofcombinedvibrationergometryandbotulinumtoxinongaitimprovementinasymmetriclowerlimbspasticityapilotstudy
AT dietmarrosenthal effectsofcombinedvibrationergometryandbotulinumtoxinongaitimprovementinasymmetriclowerlimbspasticityapilotstudy
AT sarasamadzadeh effectsofcombinedvibrationergometryandbotulinumtoxinongaitimprovementinasymmetriclowerlimbspasticityapilotstudy