Combined Treatment Fkt-Botulinum Toxin Type A (Btx-A) in XXXX with @entity48408 .

@entity1 @entity508 @entity924 @entity425 @entity1017 @entity179 @entity2057 @entity48408
UNASSIGNED: The Hereditary Spastic Paraparesis (HSP) or @entity48408 is a heterogeneous @entity179 of the spinal cord. It is genetically transmitted and characterized by a progressive @entity425 , @entity508 of the lower limbs and @entity1017 . There is no specific pharmacological treatment. The pharmacological therapy decreases the muscle tone and prevents stiffening). Physiotherapy restrains the progression of @entity2057 , delays contraction of the tendons and gives greater mobility to @entity1 affected by the disease. The aim of this study is to demonstrate the efficacy of the combined treatment Fkt and Btx-A in @entity1 with HSP. Retrospective study was conducted recruiting ten @entity1 with @entity508 according to Asworth modified scale of at least 2 and with gait deficit. They received treatment for 5 years with incobotulinumtoxinA and physiokinesiotherapy for addressing @entity508 in the lower limbs. We evaluated muscle tone with miometric measurement both at the first visit (T0), and at subsequent ones (T1 after 30 days, T2 after 3 months from the first infiltration, T3 after 4 months up to the date of the following infiltration, T4 after 5 months). Baropodometric examination has proven essential for the study of the distribution of loads in statics and dynamics. The data analysis regarding tone assessment through measurements with Myoton highlighted hypertonus reduction in all the three muscle groups examined at T1 and the maintenance of constant values up to 5 months after the first infiltration. It also showed an increase in the percentage of back foot loading in both feet up to T4 (new inoculation, p<0, 05%). Baropodometric examination in dynamics (in particular the speed of the step) showed a gradual increase in this parameter which reaches a peak at 5 months (p<0, 05%) and then declines again in conjunction with the next infiltration treatment. This study showed the benefit of combined treatment with Btx and Fkt. The use of a local muscle relaxant drug with a physical targeted exercise guarantees better mobility of the treated segments, reducing tendon retractions as much as possible, and guarantees an adequate postural alignment. Baropodometric examination highlights a more advantageous distribution load, quite essential for avoiding @entity924 due to overload. Our data observation in the 5 years study shows how the curve relative to the speed of step and the graphics related to the variations of muscle tone remain almost constant with detectable improvement.
