Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Botulinum toxin-A injections for spastic toe clawing.

Erle C H Lim1, Benjamin K C Ong, Raymond C S Seet

  • 1Division of Neurology, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. mdelch@nus.edu.sg

Parkinsonism & Related Disorders
|October 4, 2005
PubMed
Summary

Botulinum toxin type-A (BTX-A) injections targeting both long and short toe flexors, guided by electromyography, effectively treat spastic toe clawing. This method allows for lower, well-tolerated dosages and shows significant improvement in toe clawing symptoms.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

A multicenter retrospective cohort study showing that bridging thrombolysis does not achieve better outcomes compared to direct mechanical thrombectomy in stroke due to internal carotid artery occlusion.

Neuroradiology·2026
Same author

Subgroup analysis of genotype guided vs traditional warfarin dosing in Asian patients from an open label randomized trial.

Scientific reports·2026
Same author

Differentially Expressed Genes and Biological Pathways in Moyamoya Disease: A Systematic Review and Meta-analysis of Transcriptomic Studies.

Translational stroke research·2025
Same author

Spastic Paresis: A Treatable Movement Disorder.

Movement disorders : official journal of the Movement Disorder Society·2024
Same author

Left Ventricular Diastolic Dysfunction Is Associated with Poor Functional Outcomes after Endovascular Thrombectomy.

Journal of cardiovascular development and disease·2024
Same author

Low HALP (Hemoglobin, Albumin, Lymphocyte, and Platelet) Score Increases the Risk of Post-Stroke Cognitive Impairment: A Multicenter Cohort Study.

Clinical interventions in aging·2024

Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Medical Devices

Background:

  • Spastic toe clawing, a condition resulting from upper motor neuron lesions, can cause pain and functional disability.
  • Previous treatments using botulinum toxin type-A (BTX-A) on long toe flexors often required high doses and yielded unsatisfactory results.
  • High dosages of BTX-A (up to 175 units) were previously needed, with patients frequently experiencing residual toe clawing.

Purpose of the Study:

  • To assess the efficacy of BTX-A injections targeting both long and short toe flexors, using electrical stimulation under electromyographic (EMG) guidance, for treating spastic toe clawing.
  • To evaluate if this targeted injection approach could reduce the required BTX-A dosage and improve patient outcomes compared to previous methods.

Main Methods:

Related Experiment Videos

  • An open-label, prospective study was conducted involving seven patients with spastic toe clawing.
  • BTX-A injections were administered to the long and short toe flexors, guided by electrical (motor point) stimulation under EMG.
  • Outcome measures, including timed walking, modified Ashworth scale, visual analog scale for toe clawing, and functional disability, were assessed pre-injection and at six-week follow-up.

    • Main Results:

    • All patients received lower total doses of BTX-A, ranging from 40 to 90 units.
    • Significant improvements were observed in objective assessments of toe clawing (modified Ashworth and visual analog scales) and patient-reported functional disability.
    • Timed walking performance did not show improvement in the study cohort.

    Conclusions:

    • BTX-A injections targeting both long and short toe flexors, facilitated by EMG-guided electrical stimulation, are well-tolerated and effective for treating spastic toe clawing.
    • This technique allows for a significant reduction in the required BTX-A dosage compared to previous treatment protocols.
    • The improved efficacy and reduced dosage suggest a more optimal treatment strategy for patients suffering from spastic toe clawing.