The aim of the prospective observational study is to investigate the effect of a single intramuscular injection of botulinum toxin A (BoNT-A) on the spastic-atactic gait pattern of patients with lesions of the first motorneuron four weeks after injection.

The upper motor neuron syndrome a consequence of a lesion of the first motor neuron in the central nervous system causes a wide range of severe motor symptoms often accompanied by spasticity. Besides physiotherapy medical therapy with oral antispastic drugs and botulinum toxin A is recommended for the treatment of spasticity. To data, the efficacy of BoNT-A has been assessed with passive goals such as change of muscle tone or the range of motion of individual joints. Only a few randomized controlled trials investigating the effect of BoNT-A on spasticity in the lower extremities defined active goals such as the improvement in gait function as primary outcome variable.

In this retrospective study the gait pattern of patients with a lesion in the first motor neuron will be analysed using instrumental gait analysis before and three weeks after the injection of BoNT-A

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