Comparison of Botulinum Toxin A, Corticosteroid, and Anesthetic Injection for Plantar Fasciitis

2020 ◽  
pp. 107110072096109
Author(s):  
Jorge Elizondo-Rodríguez ◽  
Mario Simental-Mendía ◽  
Victor Peña-Martínez ◽  
Félix Vilchez-Cavazos ◽  
Yadira Tamez-Mata ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Plantar Fasciitis ◽  
Botulinum Toxin A ◽  
Plantar Fascia ◽  
Ankle Dorsiflexion ◽  
Control Group ◽  
Intralesional Injection ◽  
Toxin A ◽  
Treatment Groups

Background: Plantar fasciitis is the most common cause of heel pain, and injection therapies are part of the treatment modalities. This study aimed to compare 2 intralesional injection therapies for plantar fasciitis: corticosteroid and botulinum toxin A, compared with a third control group using a local anesthetic. The clinical evolution, as well as changes in the thickness of the plantar fascia and ankle dorsiflexion, was evaluated. Methods: A randomized, controlled, double-blind trial design was used. Patients were divided into 3 groups: group 1, anesthetic only; group 2, corticosteroid; and group 3, botulinum toxin A (BoNT-A). We used an ultrasonographic evaluation to measure the plantar fascia thickness. The results were evaluated using the Maryland Foot Score and a 10-cm visual analog scale. Clinical scores were recorded at the beginning of the study, at 2 weeks, and at 1, 3, and 6 months. We evaluated 78 patients for study eligibility. The 3 intervention groups were homogeneous. Results: All patients showed better clinical outcomes compared with their initial evaluations, without differences between groups at the end of follow-up. The thickness of plantar fascia diminished at the final evaluation, and ankle dorsiflexion was better compared with the initial values without difference between treatment groups. Conclusion: Considering all the evaluated outcomes, no significant differences between treatment groups were observed. The pain relief and functional improvement obtained with the different treatments was maintained during the 6-month follow-up. Level of Evidence: Level I, therapeutic study.

scholarly journals Randomized controlled study comparing clinical outcomes after injection botulinum toxin type A versus corticosteroids in chronic plantar fasciitis

2018 ◽  
Vol 4 (4) ◽  
pp. 672 ◽  
Author(s):  
Prakash D. Samant ◽  
Sachin Y. Kale ◽  
Sohrab Ahmed ◽  
Adnan Asif ◽  
Mahendra Fefar ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Clinical Outcomes ◽  
Plantar Fasciitis ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Plantar Fascia ◽  
Botulinum Toxin Type ◽  
Toxin A ◽  
Pain Scores

<p class="abstract"><strong>Background:</strong> The plantar fascia is a common condition, for which there is no consensus on the best treatment option. The aim of this study is to compare the pain and fascia thickness outcomes of patients treated with botulinum toxin A injection versus corticosteroids injection.</p><p class="abstract"><strong>Methods:</strong> 50 patients of plantar fasciitis randomly received injections of either botulinum toxin A (100 units in 2.5 ml normal saline) or methylprednisolone (2 ml of 40 mg/ml) under ultrasonographic guidance. Patients were assessed for pain using the visual analogue scale (VAS) and fascia thickness at baseline, 1 and 3 week, 3, 6 and 12 months post injection. Patients in the two treatment groups were compared for pain scores and thickness at each follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were no significant differences in the patients in both the groups at baseline. Patients in both the groups had significant improvement in VAS pain scores over a 12 months follow- up. At the end of the study (12 month follow up), the VAS pain score was significantly lower in the group of patients who received botulinum toxin A (1.68±0.62 vs. 4.72±1.02, p value=0.001). There was a significantly less plantar fascia thickness in the group of patients who received botulinum toxin as compared to those who received corticosteroids at the 3 week, 3 month, 6 month and 1 year follow up.</p><p class="abstract"><strong>Conclusions:</strong> Better clinical outcomes were observed with botulinum toxin type A as compared to corticosteroids. Similar studies need to be replicated with larger sample sizes before this can be offered as a standard treatment for plantar fasciitis patients.</p>

scholarly journals 200 U vs. 300 U Botulinum Toxin a Injections for Patients with Neurogenic Detrusor Overactivity Secondary to Spinal Cord Injury

2020 ◽  
Vol 3 (1) ◽  
pp. 1-4
Author(s):  
Lin JM ◽  
◽  
Hui Chen ◽  
Liu QL ◽  
Huang MP ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Incontinence ◽  
Botulinum Toxin ◽  
Detrusor Overactivity ◽  
Botulinum Toxin A ◽  
Control Group ◽  
Neurogenic Detrusor Overactivity ◽  
Toxin A ◽  
Cord Injury

Objective: To evaluate the d the safety and efficacy of 200 U vs. 300 U botulinum toxin A (BTX-A) injections for patients with neurogenic detrusor overactivity (NDO) secondary to spinal cord injury (SCI). Methods: We retrieved the data for the patients who receive a single dose into the detrusor of BTX-A (300 U or 200 U). The clinical outcome included maximum detrusor pressure (Pdetmax) during cystometry, voiding volume, urinary incontinence (UI) episodes between CICs per 24 hour, and complete dryness. Related adverse events were recorded. Results: From July 2015 to June 2017, 28 cases received 300 U BTX-A injections (experiment group) while 19 cases received 200U BTX-A injections (control group). There were no significant differences in baseline evaluation items (gender, age, duration of spinal cord injury, level of neurological injury, AIS scores) between the two groups. There were significant improvement in Pdetmax, UI and I-QoL from baseline in the two groups. Patients in experiment group had statistically greater improvement than those in the control group for Pdetmax (-32.09 cm H2O vs. -28.02 cm H2O, P = 0.016), mean urinary incontinence episodes (-6.18/d vs. -5.01/d, P = 0.042), complete dryness (11 vs. 2, P = 0.031), mean voiding volume (160.52 ml vs. 133.66 ml, P <0.001), and I-QoL (28.53 vs. 20.41, P <0.001). Conclusion: Preliminary results indicate that 300 U BTX-A is more effective than 200 U BTX-A for SCI patients with NDO.

scholarly journals Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 556-562
Author(s):  
Natasha A. Lannin ◽  
Louise Ada ◽  
Coralie English ◽  
Julie Ratcliffe ◽  
Steven G. Faux ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Goal Attainment ◽  
Botulinum Toxin A ◽  
Chronic Stroke ◽  
Mean Difference ◽  
Control Group ◽  
Toxin A ◽  
Upper Limb Rehabilitation ◽  
Experimental Group

Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results— In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions— Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000616572.

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