Disclosures: Alberto Esquenazi, MD, FAAPMR: Ipsen: Research Grant or Support

Objective: Evaluate the use of slow-motion video walking assessment to improve muscle selection for the injection of abobotulinumtoxinA and understand the potential benefit and the development of an image catalogue guide.

Design: Convenience sample evaluated before and after injection.

Setting: Gait Laboratory in a tertiary rehabilitation hospital.

Participants: Persons with hemiparesis 2nd to acquire brain injury (ABI) with spastic ankle foot that interferes with walking.

Interventions: Slow-motion video assessment and examination to select muscles for injection with abobotulinumtoxinA.

Main Outcome Measures: Primary: Self Selected and Maximal Walking Velocity, symmetry of walking at 4 weeks post injection. Passive Range of Motion, Modified Ashworth Scale and Tardieu Scale.

Results: The average dose of aboBoNTA injected was 1000 (± 250) units. Gastrocnemius, tibialis posterior, and long toe flexors were the most frequently injected muscles. E stim was the preferred localization technique followed by ultrasound. There was improvement in the PROM of the ankle joint, and ankle MAS and TS scores improved in all subjects. Walking velocity was increased from 0.6 meters per second (m/s) to 0.8 m/s, and 50% of the patients were able to discontinue the use of their brace while under the effect of the toxin.

Conclusions: The use of video assessment during walking helps better select the muscles for injection with botulinum toxin with improvement in walking velocity and evidence of reduction in spasticity. A catalog of images of the ankle-foot system during walking will be fully developed to guide optimal muscle selection for the injection of BoNTA in ABI.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/video-and-temporal-spatial-parameters-assessment-of-gait-pre-post-abobotulinumtoxina-treatment/