Botulinum Toxin Injections by Ultrasounds Guidance and Stretching Exercise in Spastic Toe Clawing

NCT ID: NCT02586142

Last Updated: 2015-10-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-08-31

Study Completion Date

2013-07-31

Brief Summary

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Claw toes deformity result in spasticity often seem in patients with central nerve disease. It also cause pressure sore in foot and pain during walking that didn't well improve under traditional treatment. There are few relative reports about the Botulinum toxin type A (BTX-A) injection on claw toe. The investigators' study has two main purposes:

1. assess the efficiency of BTX-A injection under ultrasonographyic guidance on improving lower extremities function, pain and spasticity in patients with symptomatic claw toes.
2. assess if regular stretching exercise can strength the efficiency of BTX-A injection on improving lower extremities function, pain and spasticity.

Detailed Description

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The investigators will enroll 50 hemiplegic stroke patients met the inclusion criteria(onset more than 6 month, lower extremity Brunnstrome stage more than stage IV, walking without assistance devices and pain during walking due to claw toe. The investigators will focus and inject BTX-A with ultrasonographyic guidance on flexor digitorum longus and brevis(both 50 unit). If patients combine ankle plantar flexors spasticity, the investigators will inject another 50 unit on both the medial and lateral head of gastrocnemius . Every patients will receive regular stretching exercise in hospital and do self stretching exercise at home for 3 months after injection. Patients will be evaluated at 2 weeks, 4 weeks and 12 weeks, 24 weeks and 1 year after injection. Outcome measure include severity of spasticity and pain, sensory and motor function, range of motion, functional assessment of lower extremity and analyze pressure under foot.

Conditions

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Cerebrovascular Accident

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Botulinum toxin type A(BTX-A) injection

To inject Botulinum toxin type A on the spasticity lower extremities for participants by ultrasounds guidance.

Group Type EXPERIMENTAL

Botulinum Toxin Type A

Intervention Type DRUG

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by ultrasounds guidance.

BTX-A injection plus stretching exercise

Inject Botulinum toxin type A on the spasticity lower extremity for participants by ultrasounds guidance. After injection, arrange them to receive stretching exercise in Kaoshiung Chang Gung Memorial Hospital 3 time per week for 3 months.

Group Type ACTIVE_COMPARATOR

Botulinum Toxin Type A

Intervention Type DRUG

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by ultrasounds guidance.

Stretching exercise

Intervention Type OTHER

After accepting Botulinum toxin type A injection, participants will be arranged to receive stretch exercise in Kaohsiung Chang Gung Memorial Hospital 3 times per week, for 3 month.

Interventions

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Botulinum Toxin Type A

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by ultrasounds guidance.

Intervention Type DRUG

Stretching exercise

After accepting Botulinum toxin type A injection, participants will be arranged to receive stretch exercise in Kaohsiung Chang Gung Memorial Hospital 3 times per week, for 3 month.

Intervention Type OTHER

Other Intervention Names

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Botulinum toxin

Eligibility Criteria

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Inclusion Criteria

* Patient with spasticity toe clawing(metatarsophalange jointextension, proximal and distal phalange joint flexion)
* MAS scale of metatarsophalange joint and interphalangeal joint more than 2
* Pain during walking, abnormal gait patterns and can't wear shoess due to claw toe
* Haven't received botox or phenol or alcohol injections before

Exclusion Criteria

* Lower extremities joint contrature, bone deformity
* Had received botox injections or phenol injections or before due to lower extremities spasticity
* Combine other neuromuscular system disease
* Severe cognition disorder or aphasia after stroke
* Significant atrophy of flexor digitorum longus and brevis
* Allergy to botox
* Infection on injection site
* Have systemic infection
* Now accept aminioglycoside or other medicine will affect neuromusclar transition
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pong Ya-Ping, MD

Role: STUDY_CHAIR

Rehabilitation

Locations

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Chang Gung Memorial Hospital

Kaohsiung City, , Taiwan

Site Status

Countries

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Taiwan

References

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Other Identifiers

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NMRPG890041

Identifier Type: -

Identifier Source: org_study_id

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