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Poststroke Postural Sway Improved by Botulinum Toxin: A Multicenter Randomized Double-blind Controlled Trial

Published:September 11, 2020DOI:https://doi.org/10.1016/j.apmr.2020.06.031
      We have read this letter with great interest and thank the authors for their comments. With regard to the effects of botulinum toxin injections, we systematically observed a decrease in the sway area in the treatment group, whereas the sway area increased in the placebo group. These clear-cut results are of considerable clinical relevance, as previous authors have pointed out.
      • Tasseel-Ponche S.
      • Yelnik A.P.
      • Bonan I.V.
      Motor strategies of postural control after hemispheric stroke.
      ,
      • Maki B.E.
      • Holliday P.J.
      • Topper A.K.
      A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population.
      The sway area generally increases in patients with stroke, resulting in postural instability and the risk of falling. The decrease in the sway area observed here can be taken to reflect the occurrence of an improvement in balance control in the patients with stroke who received botulinum injections. We confirm that the specific score used here was the Modified Ashworth Score.
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      References

        • Tasseel-Ponche S.
        • Yelnik A.P.
        • Bonan I.V.
        Motor strategies of postural control after hemispheric stroke.
        Neurophysiol Clin. 2015; 45: 327-333
        • Maki B.E.
        • Holliday P.J.
        • Topper A.K.
        A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population.
        J Gerontol. 1994; 49: M72-84