Related Experiment Video
Updated: May 23, 2026
Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation
Published on: February 19, 2019
Modification of altered ankle motor control after stroke using focal application of botulinum toxin type A
Simon F Tang1, Jia-Pei Hong, William Barry McKay
1Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital, Linkou and Chang Gung University College of Medicine, Tao-Yuan County, Taiwan.
Study Design:
Blinded, placebo-controlled, prospective clinical trial.
Purpose:
To examine the effects of botulinum toxin type A (BTX-A) injections into plantar flexor muscles in stroke patients with equinovarus gait.
Subjects:
15 post-stroke and 10 matched neurologically intact subjects.
Methods:
Modified Ashworth Scale (MAS) and Fugl-Meyer assessment of physical function scale scores along with surface EMG collected before and up to 12 weeks after BTX-A injections to plantar flexor muscle motor points in stroke subjects. Saline placebo injections were performed in a subset of stroke subject group.
Results:
MAS scores were decreased at 4, 8 and 12 weeks but F-M scores did not improve until 12 weeks post injection. Multi-muscle EMG patterns showed the return of volitional dorsiflexor activity in 11 and a decrease of antagonistic and distant coactivation in all but one of the 15.
Conclusions:
BTX-A is effective in reducing antagonistic and distant muscle activation that impedes volitional dorsiflexion.
